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U c®Wnce,vaecyval L_I vn evevuleacaen U e®v-veuiy eaeaeev U tr%ONnal aa <br /> Sanitary Landfill Sanitary Landfill Sanitary L dfill Landfill <br /> 901 Bailey Road 12 an Mateo Road 1601 Dixon L g Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Hal on Bay,CA 94019 Milpitas,CA Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726-1819 Phone(408)945-2800 Phone(209) 982-4298 <br /> • Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> 7 ELEVEN <br /> MAILING ADDRESS 3406 <br /> P.O.BOX 7'11 <br /> CIN,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> DALLAS TX.7 522'1-0711 0 GLOVES ❑GOGGLES a RESPIRATOR 0 HARD HAT <br /> PHONE <br /> 208-429-8466 ❑TY VEK ❑OTHER <br /> CONTACT PERSON <br /> 1" 41EITIM MANLEY AS AQENT_ SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE F AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION:I hereby cenity that the named material is not a hazerdous <br /> waste as defined by 40 CFR Part 261 or title 22 of the C t omi ale of regWations,has been property <br /> desodbed,c�assi8ed and packaged,and is in proper kxn tion for transportation a-oording to applicable <br /> regulationa ANO,H the <br /> waste Is a treatment residue of a previously restricted hazardous waste <br /> subject to the rand Disposal Restrictions,I oeruty and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordanoe with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261. <br /> WASTE TYPE: <br /> O DISPOSAL ❑SLUDGE <br /> ®CONSTRUCTION 'O WOOD <br /> ®DEBRIS Q OTHER <br /> ®SPECIAL WASTE <br /> GENERATING FACILITY <br /> 7 ELEVEN#32252 U <br /> TRANSPORTER NOTES: I VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> TIM A MANLEY TRUCKING.INC. <br /> ADDRESS <br /> 91511 GERBER RW 7 " C 4,23'-1 <br /> CITY,STATE,ZIP �— 4 <br /> SACRAMENTO,CA 9'5829 14, <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 916-689-4464 le <br /> SIGNA. E OF AUTHORIZED AGENT OR DRIVER DATE ROLL FF S FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> 18 YARUS <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS " <br /> ❑SOIL <br /> NSTRUCTION <br /> FACILITY TICKET NUMBER <br /> 9�14AOWFRIABLE <br /> BRIS <br /> SIGNATURE OF AUTHORIZED AGENT ASBESTOS <br /> DA <br /> ❑WOOD <br /> ' ❑ASH <br /> O SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERS MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> _; TRNSPORTER COPY MANIFEST# 4 <br />