Laserfiche WebLink
Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill 1 It 1 <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road 11401! <br /> Pittsburg,CA 94565 Half Moon Bay, CA 94019 Milpitas,CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726-1819 Phone(408)945-2800 Phone(209) 982-4298 <br /> F- '925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 ll <br /> NON-HAZARDOUS WASTE MANIFEST <br /> I <br /> :NERATOR lcc WASTE ACCEPTANCE N0. t <br /> ►ILING ADDRESS _ <br /> 77 Reale_Strinel Mail ClAc R24A 4909 <br /> rY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Sam Framisre CA 44126 U GLOVES U GOGGLES U RESPIRATOR O HARD HAT Juno <br /> ]ONE <br /> U TY-VEK U OTHER <br /> )N S01 SPECIAL HANDLING PROCEDURES: <br /> Rptuxt —r <br /> 3NA Orl MHO IZED AGENT/TITLE DATE <br /> Atdhmixed Agcad for <br /> fic Cies&Electric <br /> 3NERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous <br /> tate as defined by 40 CFR Part 261 or fide 22 of the California code of regulations,has been properly <br /> isonbed,classified and packaged,and is in proper condition for transportation a-cording to applicable i <br /> gulationa;AND,H the waste Is a treatment residue of a previously restricted hazardous waste <br /> bject ro the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> 9"dance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> I CFR Part 261- . <br /> TYPE: . I�f <br /> ISPOSAL U SLUDGE16 <br /> CONSTRUCTION Q WOOD <br /> Q DEBRIS U OTHER <br /> Q SPECIAL WASTE <br /> :NERATING FACILITY <br /> JrI1tUII lJc;hydr aior Thumion <br /> t <br /> IAi._eORTER NOTES: VE ICLE LICENSE NUMBER TRUCK NUMBER <br /> Denl3este Trans nation - <br /> IDRESS f /D <br /> $20_cire_Rt«c_ -te Ct. <br /> rY,STATE,ZIP - k <br /> ubf <br /> Windsor, <br /> IONEEND DUMP BOTTOM DUMP TRANSFER tt fs tt l <br /> ❑ ❑ 1 _i <br /> 34 '-Rift-MTOWORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> I <br /> CUBIC YARDS <br /> hereby certify that the above named material has been l <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 b It k I <br /> U SOIL <br /> :MARKS <br /> Q CONSTRUCTION <br /> CILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> 3NA-ri IRE OF AUTHORIZED AGENT DATE ASBESTOS <br /> U WOOD <br /> U ASH <br /> Q SPECIAL OTHER <br /> )ULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL,ANY UNSCHEDULED LOADS ARE SUBJECT I 'l <br /> :FUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. I bill <br /> GENERATOR COPY MANIFEST# *1 A1 q jj <br />