Laserfiche WebLink
U Keller Vanyon U ux mountLA Newoy isiano U -orwara <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 /> 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 /> i <br /> NON-HAZARDOUS WASTE MANIFEST <br /> G`ENERATOR WASTE ACCEPTANCE NO. <br /> ud_C <br /> 1 AL1141.�\J OA�.C7C'�i�lVLU.l4+ <br /> MAILING ADDRESS <br /> 77 Beale Sheet Nbil Code B24A <br /> CITY;STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Can Fr7_il6mm C A 94105 U GLOVES O GOGGLES U RESPIRATOR U HARD HAT <br /> PHONE <br /> - U TY-VEK U OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> Robert Gray <br /> SIGNATURE OFA HORIZED AGENT/ TL DATE w'-)/VZ7 <br /> A <br /> GENERATOR'S CERTIFICATION,I hereby ceitity that the above named material is not a hazardous <br /> wasteas defined by 40 CFR Part 261 or He 22 of the California code of regulations,has been properly <br /> described,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> regulatjpns;AND,H tfx waste Is a treatment residue of a prevIously restricted hazardous waste <br /> seblea to the Land asposal:Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> `accordance <br /> with the requirernent6 of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261_ - <br /> xIVASTE,TYPE: <br /> )4ispOSAL U SLUDGE <br /> 0 CONSTRUCTION O WOOD <br /> U DEBRIS U OTHER <br /> O SPECIAL WASTE <br /> ENERATING FACILITY <br /> T.:atlircr� i� � � n �.�tiirop <br /> RAN RTER zG" NINES: EHiCLE`LICENSE NUMBER TRUCK NUMBER <br /> ' este �aisiatita�an <br /> _ _ / ZIP/ <br /> AgDRESS` v t <br /> CITY;STATE, ZIP �.,,� C <br /> Windsor, CA 4 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ,� ❑ ❑ <br /> >" <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> sc+•: <br /> CUBIC YARDS <br /> hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing <br /> .,, <br /> IS true and accurate. DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> ` U SOIL <br /> EMARKS <br /> 73' O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> I. <br /> U WOOD <br /> U ASH <br /> O SPECIAL OTHER <br /> ;SCHEDULING.MUST BE MADE PRIORTO 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 /> GENERATOR COPY MANIFEST# g 1 R1 7 <br />