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 /> Phone,(925�4 98W 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 WASTE ACCEPTANCE NO. <br /> 1-MAIN Vas 17t. L14i+ll.iL <br /> MAILING ADDRESS <br /> e e,Street Mail Code Ii2A 4314-- <br /> CITY STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> t_.__94105 <br /> U GLOVES U GOGGLES U RESPIRATOR U HARD HAT <br /> PHONE <br /> 4.i5 973-3773 U TY-VEK U OTHER <br /> CONTACT PERSON <br /> Robert Ciav SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHOR ED AGENT/TITLE DATE �1lDlV <br /> SAI <br /> ER%CTOR'S CERTIFICATION:I here nify that the above named material is not a hazardous <br /> ,i1N8St9 as ti defined by 40 CFR Part 261 or 2 of the California code of regulations,has been property <br /> } described classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> regulations ANQ,Mfbiwaste is a treatment residue of a previously restricted hazardous waste <br /> sugeci,to the LarTd!Aisyp§aI Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance w ih tFie regtsremants of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> �v}O;CFR Part 26 L <br /> ASTE,TYPE: <br /> DISPOSAL O SLUDGE <br /> CONSTRUCTION O WOOD <br /> O;DEBRIS;" U OTHER <br /> ❑SPECIAL WASTE <br /> ENERATING FACILITY <br /> z L2et.,ydmtor Matron Later. <br /> _ <br /> r <br /> NOTES:` VEHICLE LICENSE NUMBER TRI1'GI( 1h�fBER <br /> DRESS' _ <br /> V • V wiv vt. <br /> <br /> .Windsor, CA 95492 <br /> HONE END DUMP BOTTOM DUMP TRANSFER <br /> ILI ❑ ❑ <br /> IIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> F: I hereby certify that the above named material has been <br /> s-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 /> U SOIL <br /> REMARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> U WOOD <br /> DASH <br /> D SPECIAL OTHER <br /> •SCHEDULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> GFNFRATOR COPY MANIFEST# 2 q l Al 9 <br />