Laserfiche WebLink
❑ Keller Canyon ❑ Ox. ,�runtain ❑ Newbylalat ,� <br /> ❑-Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road <br /> 1601 Dixon 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 (925)458-9891 Fax(650) 726.9183 Fax (408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR <br /> J.;.-' s 1.r; WASTE ACCEPTANCE N0, <br /> MAILING ADDRESS — <br /> CITY,STATE, ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE <br /> U GLOVES Q GOGGLES D RESPIRATOR O HARD HAT <br /> U TY-VEK U 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 251 or title 22 of the Califomia code of regulations,has boon properly <br /> described,classified and packaged,and is in proper condition for transportation e•cording 10 applicable <br /> regulations;AND,It the waste Is a treatment residue of a prevlovsfy restricted hazardous waste <br /> subject to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordanca wilh the requirements of 40 CFA Pad 268 and is no longer a hazardous waste as defined by <br /> 40 CFA Part 261. <br /> WASTE TYPE: <br /> Q•Dl$POSAL Q SLUDGE <br /> *CONSTRUCTION L3 WOOD <br /> Q DEBRIS Q OTHER <br /> *SPECIAL WASTE <br /> GENERATING FACILITY <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> CITY STATE,ZIP ` <br /> PHONE ' " END D MP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROL';-OFF(S) FLAT-BED VAN DRUMS <br /> L11 ❑ ❑ ❑ <br /> T�f <br /> CUBIC YARDS <br /> 1 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 /> Q SOIL <br /> REMARKS <br /> O CONSTRUCTION <br /> DE=BRtS <br /> FACILITY TICKET NUMBER U NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> 0 WOOD <br /> s' _7 - Q ASH <br /> L 2- <br /> f ❑SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 3:00 P.M.TIHE 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 rq <br /> GENERPTDR Cc3P� <br />