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❑ Keller CInyOn ❑ Ox Mountain U NQwt�l,{ ( r <br /> Sanitary Landfill Sanitary Landfill B , Sanitery LAW&fii L`at1 <br /> 90i �ile�y Rodd 12314$an Mateo Road 1601 Djxon n�11ng Road 999 S Austin Rf�ald <br /> buf A 94565 Half 966n#ay,dA 94019 Milpitas; , !905 d'[ IVi jfyog,i §ii a <br /> Phone( 5)458-9600 Phone(660)726-1619 Phone(40$)94 -2$00 Phone(209)982-4298 <br /> Fax(925)45&9891 Fax(650)726-9183 Fax(40$)262-2871 Fax(200Y 982-1609 <br /> Mary-Sanchez NON-HAZARDOUS WASTE MANIFEST <br /> GENERA <br /> WW STE ACCEPTq#(KVg, <br /> MAILING ADDRESS <br /> S=kWn, CA M03 <br /> CITY, STATE ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> DOU - 0 <br /> PHONE 0 GLOVES 0 GOGGLES U RESPIRATOR 0 HARD HAT <br /> ava I breltall0 TY VEK 13 OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES. <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> rJ <br /> GE TOR S CErMFICAnolf I hereby Dandy that the above named matodal Is not a h mardous <br /> Is as defined by 40 CFR Part 261 or dile 22 9(#0 Call9mia code of requfadons,has been pnopedy <br /> described daaaffied and packaged and Is In proper oondihon for banspoAagon a-,00F&g td appoublo <br /> regulations,ANP N the waste Is a bw*raffl residue of a pmvkmWy restricted hezargoup wean <br /> subisol to the Land Disposal Res,Adlons, 266 I oedity arra warrant that tee wasto has boon beaW In RECEIVING FACILITY <br /> ac ordanoe with ftrequlrameMs of 40 CFR Part and is no longer a hazardous waste ao,:lo*w by <br /> 40 CFR Part 261 <br /> WASTE TYPE <br /> Q DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION 0 WOOD <br /> ❑DEBRIS OOTHER <br /> C]SP <br /> GENERATING FACIA_ <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> 96 Efdt3r <br /> ADD RE 5 <br /> L1 <br /> CITY, STATE,ZIP <br /> __916381 688 4 <br /> PHONE END DUMP"' BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED PIAN DRUMS <br /> CUBIC YARDSIH Yards <br /> I hereby certify that the above fialmed material has been - - <br /> accepted and to-the best of my knowledge the foregoing <br /> Is true and accurate. DISPOSAL ME=THOD• (TO,BE COMPLETED JBY LANDFILL) <br /> DISPOsE� OTHER <br /> aEMARKS <br /> 0NSTSRUCTiON <br /> FACILITY TICKET NUMBER <br /> -0 NON-FAI ABLE <br /> SIGNATURE OFAUTHORI ,�st�r;*f'os <br /> GENT DAT <br /> ^^�) 0 WOOD <br /> q PSPECIAL OBER, <br /> SCHEDULING MUST B(RRIVALONGOING <br /> ADE PRIOR TO 3 00 P M THE DAY RIORiO EXPECTED A4RRIVAL•ANY UNSCHEDiJI_ED LOADS ARI;SUBJECT <br /> TO REFUSAL UPON DAILY DELIVERIES MUST 130 SCHEDULED WITH THE LANDFILL THE DAY,9EFORE. <br /> TRAtVSPQR7I:R COPY, MANIFEST#� � _ <br />