Laserfiche WebLink
u Kxwle". v01 ly.1. <br />}Sanitary Landfill <br />901 Bailey Road <br />Pittsburg, CA 94565 <br />Phone (925) 458-9800 <br />Fax (925) 456-9891 <br />u vaauut uuar �; LJ" IYI JUlltdlll <br />Landfill �. <br />28972 Coffin Butte Road <br />Corvallis, OR 97330 <br />."Phone (541) 745-2018 <br />Fax (541) 745-3826 <br />Sanitary Landfill <br />12310. San Mateo Road <br />Halt Moon Bay, CA 94019 <br />RRPhonp (650) 726-1819 <br />x-(650)-7,26-9183 <br />u rlew- • Islana <br />San....ry Landfill <br />1601 Dixon Landing Road <br />Milpitas, CA 95035 <br />Phone (408) 945-2800 <br />Fax (408) 262-2871 <br />NON-HAZ/ FIDOUS WASTE MANIFEST <br />Qj.parwara <br />Landfill <br />9999 S. Austin Road <br />Manteca, CA 95336 <br />Phone (209) 982-4298 <br />Fax (209) 982-1009 <br />GENERATOR <br />WASTE ACCEPTANCE NO. <br />MAIN ADDRESSs <br />%i �� <br />AIaJ �✓ <br />CITY, ST TE, ZIP_ <br />S .J G� 2 y3 <br />REQUIRED`PpERSONAL PROTECTIVE -EQUIPMENT <br />UFROVES thr. GGLES ❑ RESPIRATOR R(HARD HAT <br />❑ TY-VEK AFETY VEST <br />Com/ <br />PHONE <br />' <br />CONTACT PERSON <br />SPECIAL HANDLINCA.PROCEDURES: <br />1 ' <br />1/t' <br />SIGNATURE OF AUTHORIZED AGENT /TITLE <br />DATE <br />*k 1 <br />GERATOR'S CERTIFICATION: I hereby certify dent the above named material Is not a hazardous <br />waste as degrmd by 4p CFR Pad 261 or We V of the California code of regulations, has been properly <br />described, claselfled a�tl packaged, and Is in proper condition tar transportation according to applicable <br />regulations; AND,1 tli waste I§ a treatment residue of a previously restricted hazardous waste <br />�nburot the <br />a withnthe requlmeardt of 40 CFR Purl 268 anand warrant <br />Is noobnihe ger a hazaras base dous waste as defines by <br />40 CFR Pan 261, <br />RECEIVING FACILITY <br />- <br />WASTE TYPE: <br />,OOSPOSAL. ❑ SLUDGE <br />U CONSTRUCTION ❑ WOOD <br />❑ DEBRIS - ❑ OTHER <br />❑ SPECIAL WASTE - <br />- <br />- - - <br />I_ <br />GENERATING FACILITY <br />TRANSPORTER <br />NOTES: VEHICLE LICENSE NUMBER ' TRUCK NUMBER <br />A)12�,� ��s <br />3 <br />ADDRESS <br />TY, TAT P <br />z, 5.7. <br />HONE <br />END DUMP BOTTOM DUMP TRANSFER <br />-72.x— <br />❑ I,,❑ ❑ <br />SIGNATURE OF AUTHORIZED AGENT OR DRIVER <br />DATE <br />ROLL -OFFS FLAT-BED VAN DRUMS <br />❑ ❑ ❑ <br />1 hereby certify that the above named material has been <br />accepted and to the best of my knowledge the foregoing <br />is true and accurate. <br />CUBIC YARDS <br />DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br />DISPOSE OTHER <br />❑ SOIL <br />REMARKS <br />U 'CONSTRUCTION <br />DEBRIS <br />FACILITY TICKET NUMBER <br />❑ NON -FRIABLE <br />ASBESTOS <br />. <br />SIGNATURE OF TUMIZ5D AGE <br />DATE <br />❑ WOOD <br />—� <br />❑ASH <br />❑ SPECIAL OTHER <br />�- <br />SCHEDULING MUST BE MADE PRIOR TO 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 />Rey 11/09 NS -024 GENERATOR COPY MANIFEST Ir "i'. n ri 7 i 1 <br />