Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ', <br /> ❑ NeWb slainj <br /> SanitaryLandfill Sanitary Landfill - Sari ry Landf III f <br /> 901 Bailey Road, 1231p San Mtiteg Road 1681 DIxon� anOing RLand <br /> oad 99g illi!f <br /> r!Road <br /> Pitt§burg,6A$4565 Half Maori Via};CA 94019 Mil'Itas,CA 603 W Man&ca,CA 95336 <br /> Phone (925)458-9800 Phone(650)726-9819 Phone(408)945-2800 PhonO (209)982-4298 <br /> Fax(925).458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST w <br /> GENERATOR 1NASTE ACGAN E NO. <br /> MAILING A DRESS <br /> CITY, STATE,ZIP REQUIRED PlwRSONAL PROTEWIVE EDLJIPMFNT <br /> PHONE ❑GLOVES U GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ❑TY VEK ❑OTHER <br /> CON I AUT PERSON <br /> SPECIAL HANDLING PROCEDURES <br /> SIGN A UR A ORIZED AGENT/TITLE I DATE <br /> G ERATOR S CERnF3CAn0N f hereby cet fy that the ahave named materia!is nal a hazardous <br /> axle ae defined by 40 CFR Part 261 or title 22 of the Ca6fania code of regulations has boon property <br /> described dassMed and packaged,and Is In proper cooditlon for trensportadon axording Io applicawa <br /> regulations AND,If the waste Is a traegnent reetdue of a prrAouay restricted hazardous waste <br /> subject to the MPosal Restrictions I certify and warrent that the waste has been treated in RECEIVING FACILITY <br /> accordance wtlh the mqulrements d 2613 40 CFR Part and Is no longer a hazardous waste as defined by <br /> 40 CFA Part 261 <br /> WASTE TYPE <br /> ❑DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION ❑WOOD <br /> ❑DEBRIS ❑OTHER <br /> ❑SPECIAL WASTE <br /> GENERATING FACILITY <br /> 1876 Country Club Blvd, Stockton, CA 95203 <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMBERT UCK NUMBER <br /> ADDRESS <br /> QQn1r%CIA <br /> CITY,S , <br /> GA 196829 <br /> PHON END DUMP BOTTOM DUMP TRANSFER <br /> SIGNA ORIZED AGENT OR IVER DATE ROLL-OFFS FLAT--BED VAN DRUMS <br /> r ❑ L <br /> �c ' ? <br /> '4 0 <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been 1$ Yards <br /> accepted and to the best of my knowledge the foregoing DISPOSALMETHOD (TO BE COMPLETED BY LANDFILL <br /> Is true and accurate. ) <br /> ` DISPOSE OTHER <br /> `IEMARIC as SOIL' <br /> a CONSTRUCTION <br /> FACILITY TICKET NUMBER ;f DEBRIS <br /> Q NON,FRIABLE <br /> SIGNATURE OF UTHORIZEDAGENT F DATE ASBESTOS <br /> o WOOD <br /> ASH <br /> J O SPECIAL OTHER <br /> LM <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 TNI: DAY BEFORE <br /> -__IHA!_'�PORTER COPY_ IutnNIrFST■ C!tS CY6 4, <br />