Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <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 /> �f Phone(925)458-9800 Phone(650)726=1819 Phone(408)945-2800 Phone(209)982-4298 <br /> y' Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> 1= NON-HAZARDOUS WASTE MANIFEST <br /> :+ GENERATOR WASTE ACCEPTANCE NO. <br /> PBLi is Ow LE EL-ane <br /> MAILING ADDRESS <br /> ' Bf. kSfiw�NIU Stop B24A 4314 <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> '' ,CA 94120 0 GLOVES O GOGGLES O RESPIRATOR O HARD HAT <br /> PHONE . <br /> (415)9/3. O TY-VEK ❑OTHER <br /> CONTACT PERSON <br /> Rost SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZ D AGENT/TITLE DATE J Y <br /> .' GENERATOR'S CERTIFICATION:I herebyi that the above named material is not a hazardous <br /> ' waste as defined by 40 CFR Part 261 or title the Califomia code of regulations,has been 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 a 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 /> nc <br /> accordae 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 /> ISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION O WOOD <br /> O DEBRIS ❑OTHER <br /> O SPECIAL WASTE <br /> Elf=MATING FACILITY. <br /> Dehv&Rtcc Swim LATHROP <br /> O.RTER` NOTESr., <br /> , / ,.. _ : 1Ci NslbElfil TRUCK NUMBER'�' ' <br /> ADDRESS <br /> T �o <br /> ` V20 DinBextPe COLA <br /> CITY,STATE,ZIP <br /> Windsor,CA 45492 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (707)838-1407 ❑ ❑ <br /> SIGNATUR F AUTHORIZED AqENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑\N' <br /> ❑ ❑ ❑ <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 /> Q SOIL <br /> REMARKS O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> 0 WOOD <br /> ❑ASH <br /> O SPECIAL OTHER <br /> SCHEDULING MUST BE MADE RRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJtCT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> GENERATOR COPY MANIFEST# 9 Q 4 R q [; <br />