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U Keller canyon U (?; -ountaln U Newby Islar CJ Forward <br /> Sanitary Landfill Salary Landfill Sanitary Laftnifill Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixan Landing Road 9999 S.Austin Road <br /> Pittsburg�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 N25)458-9891 -Fax (650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> CITY, STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> { t - 0 GLOVES U GOGGLES 0 RESPIRATOR U HARD HAT <br /> PHONE <br /> 0 TY-VEK 0 OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION:I hereby cortity that the above named material is not a ho2ardous <br /> waste as defined by 40 CFR Part 261 or[ilia 22 of the California code of regulations,has been properly <br /> described,classified and packaged,and is in proper condillon for transportation a,cording to applicable <br /> regulations;AND,if the waste Is a treatment residue of■previously restricted hazardous waste <br /> sAect to the Land Disposal Restrictions,I comity and warrant that the waste has bean treated in RECEIVING FACILITY <br /> accordance month the requireman[s 0140 CFR Part 268 and is no longer a hazardous waste as deTined by <br /> 40 CPR Part 26 t <br /> WASTE TYPE: <br /> O-DISPOSAL 0 SLUDGE <br /> O CONSTRUCTION O WOOD <br /> U DEBRIS U OTHER <br /> *SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER NOTES: VEHICLE E LICENSE NUMBER TRUCK NUMBER <br /> ADDFIFSS' ; '':t 14 <br /> CITY,ISTATE;ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED V��A--yyN DRUMS <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 trice and accurate. <br /> DISPOSE OTHER <br /> -b'Sola_ <br /> EMARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> O WOOD <br /> r D ASH <br /> ❑SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> MANIFEST# 7 " <br /> GENERATOR f;OP's <br />