Laserfiche WebLink
El Keller Canyon ❑ 0; ,locarltail7 ❑ Newby Islat,J M,P6hivard <br /> Sanitary Landfill Sanitary Landfill Salutary Landfill Landfill <br /> s. <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> FiMsburg,CA 94565 Half Moon Bay, CA 94019 Milpitas,,CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726-1819 Phone(408)945-2800 Phone(209)'982-4298 <br /> Fax(9P5)458-9891 Fax(650) 726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> • NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR <br /> WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> - of <br /> CITY,STATE,ZIP' REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHO E 13 GLOVES a GOGGLES a RESPIRATOR a HARD FIAT <br /> - ' <br /> `.:f,; !, - a TY-VEK 0 OTHER <br /> CONTACT PERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION;I hereby certify that the above named material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or We 22 of The California code of reputations,has boon property <br /> described,classified and packaged,and is in proper condition for transportation a-cordriq to applicabla <br /> regulations;AND,If 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 witty the requlremems of 44 CFR Part 2M and+s no longer a hazardous waste as dolined by <br /> 40 CFR Part 261. <br /> WASTE TYPE: <br /> Q QISPOSAL U SLUDGE <br /> �Q CONSTRUCTION a WOOD <br /> 0 DEBRIS a OTHER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER 1 NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS sae''"_� 3 '''• rf3^.f <br /> CI STATE,ZIP'- I <br /> PHONE;' END UMP BOTTOM DUMP TRANSFER <br /> SIG ATURE OF` UTHOR ZED AG NT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 <br /> is true and accurate. DISPOSAL METHOD: {TO BE COMPLETED BY LANDFILL} <br /> DISPOSE OTHER <br /> Ell SOIL <br /> EMARKS <br /> R CONSTRUCTION <br /> DEBRIS <br /> FACILITY TICKET NUMBER a NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE`OF AUTHORIZED AGENT DATE <br /> a WOOD <br /> ^�r J O ASH <br /> r f�kJl r SPECIAL T <br /> L O FiER <br /> SCHEDULING MUST BE WKbE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL i-ANY UNSCHEDULED LOADSARE SUBJECT <br /> TO REFUSAL: UPON,ARRIVAL:.ONGOING:.DAILY DELIVERIES MUST BE SCHEDULED: I TH THE LANDFJLL..THE:.DAY-BEFORE. . <br /> MANIFEST* <br /> GENERATOR C0P1' ' �. <br />