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lJ r��ucl val1yv11 LJ vA IYIVUIIld111 U 14t:VVLJy I,Iid11U i-ii rurwara <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill s ` 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 /> Packfiic Gas Lk. Elcctn <br /> MAILING ADDRESS <br /> AnAC1— <br /> Beale Street (-'ode RMA t7V2 <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Sap Fran 5�c.f?" CA 94-12(1 ❑GLOVES 0 GOGGLES D RESPIRATOR 0 HARD HAT <br /> PHONE <br /> 0 TY VEK 0 OTHER <br /> CONTACT PERSON <br /> Z Obert CiTay SPECIAL HANDLING PROCEDURES: <br /> SIGNATURF,GF AUTHORIZE AGENT/TITLE DATE <br /> Z'kudwr(Z. Ag"for <br /> Paiatic Gns&FJtmic <br /> * t ,� Z,. r.,.._....... <br /> GENERATOR'S CERTIRCATIM I hereby certify that the above named material is not a hazardous <br /> waste as defined by 40 GFR Part 261 or title 22 of the California code of regulations,has boon property <br /> described,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> regulations;AND,If the waste Is a treatment residue of■previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions,I certify and warrant that 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 /> WASTE TYPE: <br /> DISPOSAL O SLUDGE <br /> CONSTRUCTION O WOOD <br /> O DEBRIS U OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> in�rnit>>iI.iJci�ycuaiuzi€��z�niorr <br /> RANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> llenBesW lranaportation <br /> ADDRESS / l' <br /> 20 L)e-n_B est .CL <br /> CITY, STATE,ZIP <br /> Windqor, C; 97 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ill R'A _ d ❑ ❑ <br /> SIGNATURE OF,AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <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: (TO BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS U SOIL <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> O WOOD <br /> U ASH <br /> * U SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORT0 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO..REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> -----_ -_-- - uAnuccoTa 6:117 nnr) <br />