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.....v, v yam. Vw _ fvt:wU' 1:ioll4 <br /> Sanitary Landfill Sanitary Landfill Sanitary Lar l[ Landfill <br /> 9C1 Bailey Road 10 San Mateo Road 1601 Dixon _ondine Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 %%Of Moon Bay,CA 94015 Milpitas,CA55035Manteca,CA 95336 <br /> Phone (925)458-9800 Phone(650)726-1819 Phone (408)945.280C 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 /> MAILING ADDRESS <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE aGLOVES ❑GOGGLES O RESPIRATOR "ARD HAT <br /> O TY-VEK ❑OTHER <br /> CONTACT PERSON <br /> _ SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT TITLE DATE <br /> GENERATOR'S CERTIFICATION:I hereby osiety that the above narrwd matenal is not a hazardous <br /> waste as Defined by 40 CFR Part 261 or title 22 of One Caliloma rods of regulations,has been property <br /> described,daseified and Paduged,and is in Proper cortd6ion for banapodedon a-cording to applicable <br /> regulations;AND,N the wash Is a traaDrient raaldue of a preetauay resbk ed haaardoua wase, <br /> aubpx to the Land Disposal Restriction,I candy and wananl Mel lite waste has been treated in RECEIVING FACILITY <br /> xmrdartce with 6w requirements of 40 CFR Part 266 artd is no Inger a hazardous waste as defined by <br /> 40 CFR Pan 261. <br /> WASTE TYPE: <br /> DISPOSAL O SLUDGE <br /> ❑CONSTRUCTIONO WOOD <br /> O DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> i r7. <br /> ADDRESS <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE,OF AUTHORIZED AGENT OR DRIVER DATE ROLL OFFS FLAT-BED VAN DRUMS <br /> qtr r <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: <br /> Is true and accurate. (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> REMARKS O SOIL <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> ❑ NON-FRIABLE <br /> SIGNATUREOFAUTHORIZED AGENT DATE ASBESTOS <br /> Q WOOD <br /> ❑ASH <br /> - ❑ SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIOR TO 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 a n u <br />