Laserfiche WebLink
C3-Keller Canyon ❑ Oountain Newby Islay Nandfill <br /> orward <br /> Sanitary Landfill Sawtiary Landfill Sanitary Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Hal(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 /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WAS IE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> 60!3 O 11WAIWINU"e, "I" <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GLOVES Q GOGGLES ❑RESPIRATOR Q HARD HAT <br /> PHONE <br /> TY-VEK ❑OTHER <br /> CONTACT PERSONPECIAL HANDLING PROCEDURES; <br /> r <br /> SIGNATURE OF AUTHORIZED AGENT If TITLE DATE <br /> GENERATOR'S CERTIFICATION:l hereby oariffy khat Cw above maned rnstadaf In net a hazardous <br /> waste as defined by 40 CFR Part 261 or tffe 22 of dw Cafffomia code of regulon,has been property <br /> described,classified and packaged.And is in proper cartcfif w for transporls4on a-oording to applIcAbfe <br /> teguladons;AND,M the waste Is e wastareert reekho of a prrAou*reetrketsd hazar0pvp waste <br /> auow�I�wM the reqund uirements of 4a CFR Pam 2arrd68 er�nis owtarver waste <br /> � Ardrdoubs beim <br /> ams In <br /> by ECEIVING FACILITY <br /> 40 CFR Part 261. <br /> WASTE TYPE: - -- - <br /> Q DISPOSAL ❑SLUDGE <br /> O CONSTRUCTION U WOOD <br /> U DEBRIS O OTHER <br /> O SPECIAL WASTE- <br /> GENERATING FACILITY <br /> ON <br /> TRANSPORTERNOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATEr ROLL-OFFS FLAT-BED VAN DRUMS <br /> BIC YARDS <br /> I hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (T6 BE COMPLETED BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS SOIL <br /> CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> NON+8IAj3LE <br /> AS <br /> SIGNATUR F A O IZE ENT <br /> ASH <br /> SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR)(O 3:00 P-M-THE DAY PRIORTO EXPE CTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> "CO ILEI=USA1_ UPON ARRIVAL. ?'PbOING DAILY DELIVERIES MUST SE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> LANDFILL COY MANIFEST fi' 25126 <br />