Laserfiche WebLink
Sanitary Landfill Landfill Sanitary Landfill Sanitary Land',ill I-:af tri' <br /> 901 Bailey Road 28972 Coffin e Road 12310 San Mateo Road 16 ixon Landing Road <br /> Pittsburg, CA 94565 Corvallis, OR y 330 Half Moon Bay, CA 94019 Milplfas. CA 95035 PJi t it <br /> Phone (925) 456-9800 Phone (541) 745-2018 Phone (650) 726-1819 Phone (408) 9,15 2800 <br /> Fax (925) 458-9891 Fax (541) 745-3826 Fax (650) 726-9183 Fax (408) 262-2.871 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR __- - WASTE ACCEPTANCE NO. I <br /> MAILING ADDRESS _ <br /> CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE <br /> PHONE 'J-GLOVES U GOGGLES U RESPIRAislTo <br /> _ U TY-VEK 6 SAFETY VEST II <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURF-S- <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> 7k <br /> GENERATOR'S C'M[IFICATION-I hereby ce,vy that the above named material is not a hazargous <br /> waste as fttlmd by 4C CFR Part 261 or title 22 of the California code of regulations,has been properly <br /> desciibed,classllied and packaged,and is in proper conditlon for transportation according to applicable <br /> regulntinns;AND,If the waste is a treatment residue of a previously restricted hazardous waste <br /> subject to the Land Disposal Resluclinns I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance.with the reQ16rements of 40 CF11 Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Pan Pei, <br /> WASTE TYPE:— _ .... . -- <br /> U DISPOSAL U SLUDGE <br /> J CONSTRUCTION U WOOD <br /> ..3 DEBRIS U OTHER <br /> l.7 SPECIAL WASTE -- <br /> GENERATING FACILITY ----__—_............ . . . _ .. ...... <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER <br /> ADDRESS --— -- -- — - -- <br /> CUY, STATE, ZIP <br /> PHONE END DUMP BOTTOM DUMP 'ii;. .ti=::'f <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL--OFF S) FLAT-BED V/\1 I i <br /> CUBIC YARDS <br /> i <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing (To BE coMPLEY�D V,' <br /> IS true and accurate. <br /> DISPOSAL METHOD: <br /> DISPOSE <br /> REMARKS U SOIL <br /> J CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> NON-FRIABLE <br /> ------ — ASBESTOS <br /> SIGNATURE CF AUTHORIZED AGENT DATE . <br /> r <br /> - — — J WOOD <br /> 1 <br /> J ASH/ — I <br /> -- U SPACIAI,!OTHER <br /> SCHEDULING MUST BE MADE PRI!PR TO 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRIVAL.ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARn1VAL,•'6NGO1NG DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> Rev 11109 NS-024 �' MANIFEST# <br /> GENERATOR COPY , <br />