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LJ 1%CnCr VdllyUn,.,, L_j Vx iviounlaln L_1 NeWDy ISlana t-Orwara <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill ' Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <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 /> 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 /> MAILING ADDRESS <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> San Tiranr.'.cr. e CA 941')0 <br /> PHONE 0 GLOVES D GOGGLES ❑ RESPIRATOR 0 HARD HAT <br /> -- ❑TY-VEK O OTHER <br /> CON O SPECIAL HANDLING PROCEDURES: <br /> SIGNATORS OP AUTHORIZED AGENT/TITLE DATE <br /> ' Anthocind Ag at fov <br /> Gas&Electric /� ............... <br /> v� / r , � L. <br /> iiilie <br /> GENERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous <br /> MT.- <br /> waste as defined by 40 CFR Pan 261 or We,22 of the Cattlomia code of regulations,has been property <br /> described,classified and packaged,and Is in proper condition for transportation a'cording to apps cable <br /> regulations;AND,If the waste is a treatment residue of•previously restricted hazardous waste <br /> subject to the land Disposal Restrictions.I certity and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance with the requirements of 40 CFA Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFA Part 261. <br /> WASTE TYPE: <br /> DISPOSAL O SLUDGE <br /> r❑CONSTRUCTION O WOOD <br /> ❑DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> f`Thmntntun Dohy&4fur iinc�rnif�n <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> UenBeste T ram ortatron ,- <br /> ADDRESS 76)(1 U <br /> ".0 1-N-nRegte,: ('.t. <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGN .,A I`31�ED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: ('O BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS 0 SOIL <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> SIGNATURE OFAUTHORIZED AGENT DATE ASBESTOS <br /> 0 WOOD <br /> O ASH <br /> 0 SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />