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❑ Feller Canyon ❑ 6wAillouintain <br /> ❑ Newby Isla ❑_-_Forward <br /> ar <br /> Sanit Landfill <br /> Y Sanitary Landfill Sanitary Landfill Landfill <br /> £,03 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Red <br /> Pittsburg, CA 94565 Halt Moon Bay, CA 94019 Milpitas,CA 95035 Manteca,CA 95336 <br /> phone(925)458-9800 Phone(650) 726-1819 Phone 408 945-2800 <br /> Fax(925)458-9891 Fait(650)726-9183 Fax(4 8)262-2871 Fax(209) 982- 1100998 <br /> NON-HAZARDOUS WASTE MANIFEST" <br /> GENERATOR '''' �•�, r: - .;••'r 'y ,i,;.?: k,-'��;,_.•,,� �:;- WASTE ACCEPTANCE N0. <br /> MAILING ADDRESS <br /> CITY,STATE,Zip REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE r` O GLOVES C GOGGLES O RESPIRATOR tD HARD HAT <br /> ❑TY-VEK d OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE. <br /> -'-GENERAfOR'S CERTIFICATION;f hereby certify Ilial the ab6vo named malerlal is not a hazardous <br /> waste as defined by 40 CFA Part 261 or title 22 of the Calffomia code of regulations,has been proporty <br /> descrihed,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> regulations;AND,It the waste is a treatment restdw of a previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions,i certify and warrant that the waste has boon Irealed in RECEIVING FACILITY <br /> accordance with the requirements Of 40 CFA Part 268 and is no longer a hazardous waste as dolinnd by <br /> 40 CFR Part 261. <br /> WASTE TYPE: <br /> Cl D{SPOSAL ❑SLUDGE <br /> ❑CONSTRUCTION U WOOD <br /> ❑DEBRIS OOTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK!NUMBER <br /> ADD E_SS� <br /> CITY,STATE,ZIP <br /> 7 <br /> i <br /> PHONE fir..'., .� _.. ,'�•' <br /> END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OFAUTHORI ED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAIN DRUMS <br /> U ❑ <br /> CUBIC 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: (TO BE COMPLETED BY LANDFILL) <br /> is true and accurate. <br /> DISPOSE OTHER <br /> EMARKS O SOIL <br /> .O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> O WOOD <br /> Q ASH <br /> t! O SPECIAL OTHER <br /> SCHEDULING MUST BEAWADE PRIORTO 3:00 P.M.'THE DAY PRIORTO:EXP>ECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO.REFUSAL UPON ARRIVAL..ONGOING DAILY DELIVERIES MUSS' BE SCHEDULED-WITH THE:L:ANDFILLTHE-DAY:BEFORE... <br /> MANIFEST 0 7 <br />