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U Kelier canyon LJ ux mountain LJ Newby Island Forward <br />' Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S Austin Road <br /> Pittsburg,CA 94565 Half Moon Bay, CA 94019 Milpitas, CA 95035 Manteca, CA 95336 <br /> 'hone(925)458-9800 Phone (650)726-1819 Phone (408) 945-2800 Phone(209) 982-4298 <br />' x(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br />' GENERATOR WASTE ACCEPTANCE N0. <br /> Manna Pro Carp <br /> MAILING ADDRESS <br /> S-p—ir—R70 Parkrive 1.50 3278 <br />' CITY STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> St Lows, MO 63005, ❑GLOVES O GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> PHONE <br /> ❑TY-VEK Q OTHER <br />' CONTACT PERSON <br /> an 6-mith SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT 1 TITLE DATE <br /> * zg _Xf <br /> GENERATORS CERTIFICATION I hereby certify that the above named material is not a hazardous, <br /> waste as defined by 40 OFFS Part 261 or title 22 of the California code of regulations has beenproperty <br />' described classified and packaged and is In proper condition for transportation a'cording to appllCabfe <br /> regulations AND,it the waste Is a treatment residue of a previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions I certify and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261 <br />' WASTE TYPE <br /> •DISPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION O WOOD <br /> ❑DEBRIS 0 OTHER <br /> O SPECIAL WASTE ` <br /> GENERATING FACILITY ' <br /> 4004 S EI Dorado Stockton, CA 95206 t <br />' TRANSPORTER _ I�OTk);S vEH CLExL10EN E NUMBER , TPIJGK DUMBER <br /> �,�� -524ADDRESS F <br /> 88961 Elder Z75eek Rd <br /> CITY, STATE,ZIP <br /> Sacramento, . A 95828 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br />' 916 381-6864 ❑ Q <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE r ROLL-OFFS FLAT-BED VAN DRUMS <br /> CU131C YARDS <br /> I hereby certify that the aboMe flamed material has been 18 Yards <br /> accepted and to the best of riy knowledge the foregoing DISPOSAL METHOD t�T BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br />' DISPOSE OTHER <br /> EMARKS ❑ SOIL <br />' ❑ CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> t O N N-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OFAUTHOBIZ DA Ef T DATE <br />' l U WOOD <br /> ❑ASH <br />' I O SPECIAL OTHER <br /> SCHEDULING MU B MADE PkIORTO 3.00 P M THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UP _ARAWAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />' _ GENERATOR COPY <br /> F,JANIFEST# <br /> Fivc-Kr1 _C71711 52224 <br />