Laserfiche WebLink
Keller Canyon ❑ Ox.Mountain ❑ Newby Island Forward <br /> Sanitary Landfill Sanitary.Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road ..e. 12310 San Mateo Road 1601 Dtxdp Landing`--Road ' 9999 5'/kstt4Road <br /> Pittsburg4,CA�9+3565; Half Moon Bay,CA-94019 Milpita�s;� 95035' Manteca` A 95336 <br /> Phone{925j 45$-9800 Phone"(650)726=1819 e�4 , 45-2800 PhonPhone -9824298 <br /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262'-2871 ' Fax(209)98261009' <br /> NON-HAZARDOUS WASTEAAKNIFEST <br /> .,E ERATOR _ �,y t <br /> . . .� . <br /> WASTE'ACCETANCE NM <br /> 13NG ADDRESS <br /> 7;Beale.Strect Mail Code B24A <br /> rTATE,ZIP REOUIREDPERSONALPROTEOTIVE°EQUIPMENT ' <br /> pari F>rargr_.iarn-CA 941 O'S <br /> D GLOVES 'O GOGGLES O RESPIRATOR D HARD HAT, <br /> -S 0 TY-VEK ❑OTHER <br /> CT; ERSON SPECIAL HANDLING PROCEDURES: <br /> C=amtt Gray <br /> r-'10f,*TURE.OF AUTHORIZED.AGENT.]TIT DATE �JG/✓ <br /> a TOR'$CERTIFICATION:1 herebycertify.that the'-above named material is not a hazardous - <br /> as tlefined by 40 C,FR Part 261 or fide 22 of the.California code of regulations,has been property. - <br /> w fled and packaged,and rs iq propebcooddjon for transportation a-cording to applicable <br /> D,If the waste Is a.treatment refrfdusbf s prevbuaty restrkted luzerdous waste = <br /> bispgsal Restrictions.I certify vfd.*wr mt that the:waste has been treated in <br /> t#r the requirements M 40 CFR Part 268'and is Ad longer a hazardous waste as defined by RECEIVING FACILITY <br /> { E - <br /> F. <br /> O SLUDGE - <br /> r Q 1 RUCTION. U WOOD' <br /> U OTHER" <br /> ,ECIALWASTE <br /> CRATING,%Q -Y <br /> y <br /> Jig,MPI <br /> F TATE, t 3. la C < <br /> ,- <br /> v5492 <br /> ' ,.. END DUMP BOTTOM DUMP _ TRANSFER, <br /> 13,A UR OF,AUTHORIZEDAGENT:OR.DRIVER DATE ROLL-OFF(S) FLAT-BED VAN _ DRUMS' <br /> _ <br /> CUBIC,YARDS <br /> Ireb <br /> certify that the above named material has been <br /> Y <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 /> O SOIL <br /> EMARKS <br /> U CONSTRUCTION <br /> NCILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> JGNATURE OF AUTHORIZED AGENT DATE <br /> U WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> U_ G MIT <br /> UST BE MADE PRIORTO O PM:THE DAY PRIORTO'EXPE(`F D R IVAL ANY UNSCHEDULED LOADS ARE SUBJECT E. <br /> 'EFUSAL UPON ARRIVAL:`ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAYBEFORE. <br /> GENERATOR COPY MANIFEST# n g l R-17 <br />