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❑ Meller Canyon ❑ Ox Mountain U Newey tstana <br /> S-initary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Batley Road 12310 Sari Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> ,Pittsburg,CA 94565 Halt Moon gay,CA 94019 Milpita§, CA 95035 - Manteca,CA 95336 <br /> Phone(925)q58-9800 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 WASTE ACCEPTANCE NO. <br /> Mery Sanche7 <br /> MAILING A15DRESS <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECT UIPMENT <br /> PHONELGLOV�S ❑GOA LES ❑RESPIRATOR ❑HARD HAT <br /> rr1 <br /> O TY VEK Q OTHER <br /> CONTACT PERSON <br /> _ SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENER QR 5 CFATWICATiON i hereby cartity that the above named material Is not a hazardous <br /> wast s defined by 40 CFR Part 261 or tide 22 of the Caldomia code of regulations has been property <br /> desGrbed Wassdiad and packaged and Is In proper condition for transportation a-cording to appIkable <br /> regulations AND If the waste is a treatment restdus of a previously restricted hazardous waste <br /> subject to the Land Disposal Reatricdons 1 certify and warrant that the waste has been treated In RECEIVING FACILITY <br /> abcotdance wrth the requirements of 40 CFR Part 268 and is no iongar a hazardous waste as deafted by <br /> 40 CFA Pan 261 <br /> WASTE TYPE <br /> C1 DISPOSAL 0 SLUDGE <br /> O CONSTRUCTION ❑WOOD <br /> ❑DEBRIS ❑I OTHER <br /> *SPECIAL WASTE <br /> GENERATING FACILITY <br /> 1375 Country Club Blvd Stockton, CA 95203 <br /> TRANSPORTER NOTES VEHICLE LICENSE NUMB R TRUCK NUMBER <br /> ADDRESS r � - 3 <br /> Creek Rd- <br /> CITY, STATE,72P <br /> PHONE END VMP BOTTOM DUMP TRANSFER <br /> SIGNA A-13THORL7,ED AGENT OR DRIVER DA/TE ROLL-OFFS FLATBED VAN DRUMS <br /> ffL JiJ14 <br /> A <br /> } <br /> y CUBIC YARDS, t <br /> I hereby certify that the above named material has been $ Yard» <br /> accepted and to the best of my knowledge the foregoing <br /> DISPOSAL METHOD {TO BE COMPLETED BY LANDFILL} <br /> Is true and accurate, ` <br /> 'DISPOSE OTHER <br /> 0 SOIL <br /> FIEMARKS <br /> 0 CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> 0 NON FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUT RIZED A NT C t DAT <br /> f � � ❑WOOD ; <br /> I I 3IL- <br /> 0 <br /> ❑ASN ; <br /> r�� 4 •�� , SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 3 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL aANY UNSCHEOPLED LOAD$ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFOR9 <br /> TRANSPORTER COPY MANIFEST 9 L. 2 f <br />