Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island �xForward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill reLandfill <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 /> WASTE ACCEPTANCE NO. <br /> a. -c.Jas cc 4 <br /> MAILING ADDRESS A;1 <br /> e Stmet. Mail Code B24A <br /> CITY STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> -ah krarirnscA 94105 <br /> O GLOVES ❑GOGGLES O RESPIRATOR U HARD HAT <br /> PHONE <br /> 415 973-3771 O TY-VEK O OTHER <br /> MTACT PERSON - <br /> Ro <br /> Gray SPECIAL HANDLING PROCEDURES:bvil <br /> SIGNATURE OF AUT RIZED AGENT/TIT DATE <br /> GENERATOR'S CER ICATION:I hereby certify tAal the above named material is riot a hazardous <br /> 'waste as defined by 40 CFR Part 261 or title 22 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;AND,If the waste Is a treatment,residue of a previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions,l certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Pail 268 and is no longer a hazardous waste as defined by <br /> i40 CFR Part 261 <br /> WASTE TYPE. <br /> ISPOSAL U SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRIS U OTHER <br /> (a SP.EML WASTE <br /> .,Y <br /> GENERATING FACILITY <br /> T,athrop l)chydrator Station Lathrop <br /> ., SORTER w NOTES' VEHICLE"LICENSE NUM - TRUE FABER <br /> MU;_1 I- <br /> ADDRESS <br /> v <br /> CITY,.STATE,ZIP ZIP <br /> : . <br /> Windsor, CA 95492 <br /> PHONE END UMP BOTTOM DUMP TRANSFER <br /> ,707,)838-1407 ep ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> t, CUBIC YARDS <br /> to <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing <br /> ;y) DISPOSAL METHOD: <br /> is true and accurate. (TO BE COMPLETED BY LANDFILL) <br /> r <br /> DISPOSE OTHER <br /> U SOIL <br /> EMARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> U WOOD <br /> U ASH <br /> U 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# 0 t-1.4 0 O 0 <br />