Laserfiche WebLink
❑ Ke1 yon ❑ Ox Mountain El Newby Island` Forward <br /> Sart1tary 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 <br /> Parc Gas t: 1U;'1CCtr"C WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> A QA — <br /> .tale Street Mi -r�v- <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> atn_ F c'scn CA 94190 <br /> PHONE U GLOVES O GOGGLES ❑RESPIRATOR U HARD HAT <br /> r U TY-VEK U OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OFAl7THORIZED AGENT/TITLE DATE <br /> Authorized Agwd for <br /> Pacific Gus&Electric <br /> GENERATOR'S by 40 I AT t 2 1 by ce that the above named material is not a haze s <br /> None <br /> waste as defined by 40 CFR Part 261 ort de 22 of the California code of regulations,has been property <br /> deuxibed,classified and packaged,and i,g in proper condition for transportation a'cording to applicable <br /> regulations;AND,If the waste Is a treatment residue of a p—busty restricted hazardous waste <br /> subject to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by RECEIVING FACILITY <br /> 40 CFR Part.261. <br /> WASTE TYPE: t <br /> U ISPOSAL U SLUDGE <br /> ,NCONSTRUCTION O WOOD <br /> �URlEBRIS U OTHER <br /> U SPECIAL WASTE <br /> GENERATING FACILITY <br /> Thou-don Dultydratof Thomion <br /> ArVSRORTER <br /> este 'ramportatton 7 <br /> NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS � ^ --- <br /> Pr► t <br /> CITY,STATE,ZIP <br /> END DUMP BOTTOM DUMP TRANSFER <br /> SIGN ED AG r TOR DRIVER DATE ❑ ❑ : <br /> ROLL OFFS) FLAT-BED VAN MS <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been f <br /> accepted and`to the best of my knowledge the foregoing <br /> Is true and accurate. DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER ` <br /> EMARKS'' U SOIL # I! <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS i <br /> U NON-FRIABLE .. <br /> SIGNATURE OF AUTHORIZED AGENTDATE ASBESTOS 1 <br /> } <br /> U WOOD <br /> ;• U ASH <br /> U SPECIAL OTHER { <br /> ULING MUST RE MADE PRIORTO 3:00 P.M-THE DAY PRIORTO EXPE ARRIVAL a ANY UNSCHEDULED LOADS ARE UBJECT r t <br /> REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE�HEDULEp WITH THE LANDFILL THE DAY BEFORE. 1 <br /> (2FNFaATrw nnov = ....,..-.-..�,. A -A A' r%�w <br />