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1—1 r.vnc. vcAr,yyn,t,, U vn tvlvutttant U t'@avvuy tatanu rUtwdIU <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 /> f it7V7 <br /> CITY, STATE,ZIP-72 Beak "'Iccet ry REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> R;4Fr,anrivnn ('A 9x1176 D GLOVES D GOGGLES D RESPIRATOR D HARD HAT <br /> PHONE <br /> D TY-VEK O OTHER <br /> CON O <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATOnS OrAUTHORIZED AGENT/TITLE DATE <br /> { A16ori7xr:int fix <br /> _p. ;fig IIej& c <br /> GENERATOR'S CERTIFICATION:I hereby ,certlty,that the above named material is not a hazardous out <br /> waste as defined by 40 CFR Part 261 or title 22 of the Catifomia code of regulations,has been property <br /> described,dassKed and packaged,and is in proper condition for transportation a cording to applicable <br /> regulations;AND,if the waste is a uvatment rasfdue of a previously rsstrlcted hazardous waste <br /> subject to the Land Disposal Restrictions,I oerbfy and warrant Thal the waste has been treated in RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261. <br /> WA T TYPE: <br /> DISPOSAL D SLUDGE <br /> 'CONSTRUCTION D WOOD <br /> ❑DEBRIS D OTHER <br /> D SPECIAL WASTE <br /> GENERATING FACILITY <br /> ThumLon I)chydrdlur 7110 <tiun <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> Llc Beste Transportafion <br /> ADDRESS <br /> x).f)114-.TITA"te _t, <br /> CITY, STATE,ZIP <br /> Windsor, <br /> q54c)-' <br /> PHONE END DUMP BOTTOM DUMP TRAN F R <br /> SIGN A IED ENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> 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 /> ❑ <br /> EMARKS SOIL <br /> D CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> O WOOD <br /> I D ASH <br /> D 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 /> --- ..--II &AAAItcCCT u 0 A 7 rl-7'7, - <br />