Laserfiche WebLink
Keller Canyon. ❑ Ox Mountain ❑ Newby Island Forward <br /> °SanitaW,�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 P, <br /> NON-HAZARDOUS WASTE MANIFEST <br /> :NERATOR WASTE ACCEPTANCE NO. <br /> Pacific OX <br /> A�• G.0 \Jr_�D {JAL,El4ct11V <br /> LILING ADDRESS <br /> 77 Rewe Street Mail C odc B24 A 49109 <br /> FY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> San l+ramc:jco{i CA 941 WI U-15-LOVES Q-GOGGLES U RESPIRATOR O+m'nb HAT <br /> 'SNE <br /> -- U TY-VEK O OTHER <br /> INT CT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> 3NATURE OF AUTHORIZED AGENT/TITLE DATE <br /> / d Agent f(w 9 <br /> / Pae' cCms&Elo c $ <br /> .... Igb I?iiuiie I s��•� <br /> NERATOR'S CERTIFICATION:1 hereby certify that the above named material is not a hazardous <br /> tste as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> scribed,classified and packaged,and is in proper condition for transportation a-cording to applicable I <br /> juiations;AND,If the waste ts a treatment residue of a previously restricted hazardous waste I <br /> bjW to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> cordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> CFR Part 261- <br /> 1ST TYPE: <br /> DISPOSAL U SLUDGE <br /> 13 CONSTRUCTION U WOOD I ` <br /> 0 DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> :NERATING FACILITY <br /> I R(Ymivuin.nyuraiur i numton @ <br /> W <br /> AN n JRTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> Den.Beste l*ransportattort <br /> DRESS �. <br /> N210 LknnHlcst�, C1. <br /> 'Y,STATE,ZIP elfv <br /> Windsor, CA 95492 <br /> ONE END DUMP BOTTOM DUMP TRANSFER <br /> (27 ❑ L)'NA U F - THORIZED ENT qR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN 'DViUMS <br /> ❑ ❑ ❑ ❑ <br /> 07"m CUBIC YARDS I � <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 /> MARKS U SOIL <br /> U CONSTRUCTION <br /> -ILITY TICKET NUMBER DEBRIS i <br /> U NON-FRIABLE <br /> ASBESTOS i <br /> ;NATURE OF AUTHORIZED AGENT DATE <br /> U WOOD 1 <br /> U ASH <br /> U SPECIAL OTHER <br /> )UUNG#RUST BE MADE PRIORT0 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANYUNSCHEDULED LOADS ARE SUBJECT <br /> FUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL TIIJE DAY <br /> [�BEFORE. <br /> GENERATOR COPY MANIFEST# 419.8'8 <br />