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Jul. I 2006 9: 05AM Advanced GeoEnvironrnentaI No, 5366 P. 2 <br /> 0 Keller Canyon ❑, Mountain ❑ Newby Isla )qandfill <br /> orward <br /> Sanitary Landfill SanitaryLan'dfill Sanitary Landfill <br /> 901 Bailey Road 12310 San Mateo!`load 1601 Dixon Landing Road 9999'S,Austin Road <br /> Pittsburg,CA 94,565 Half Moon Bay,CA 94019 Milpitas,CA 95435 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726.1819 Phone(408)945-2800 Phone(209)982-4298 <br /> Fax(925)456-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE::MANIFEST <br /> GENERAT R WASTE ACCEPTANCE NO. <br /> AIQ7` <br /> MAILING ADDRESS _ <br /> CITY, TA ,zip. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE + Q GLOVES Q GOGGLES O RESPIRATOR O HARD HAT <br /> ❑TY-VEK Q OTHER <br /> CONTACT PERSON <br /> � r � SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OFAI rrWr1PI'7Pn Ar-ENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION;t hereby comity that the above named material+e not a hazardous <br /> waste u defined by 4o CfR Fart 261 or tile 22 61 the COMM coda Of 1`890890ns,nae been properly <br /> described,ciassofed and paa&ro,and to In proper oommon for.transponation x'mdin9 to applicable <br /> regUatims;AND,ff the waste Is a tmabnent raaidus of a prwbualy restricted heraldoue waste <br /> wA*m t to the Land Disposal Rearetions,I cer iry and warrant That the waste has bw treated in RECEIVING FACILITY � <br /> aoeordance,rith the raquirmnenrs of 40 CFR Parr 269 and is nv huger a hazardous waste as defined by . . <br /> 40 CFR Pan 267. -1 <br /> WASTE TYPE; . <br /> G CA <br /> , DISPOSAL O t1DGE � � '- ✓ - <br /> ❑CONSTRUCTION 0 WOOD <br /> O DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> e:2 ra 3 it <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> .ADDRESS L}6 T <br /> J <br /> C ATE,71P <br /> vJ � • 111 <br /> PHONE" END DUMP BOTTOM DUMP TRANSFER <br /> Z7��Cjm 75- 1 <br /> SIGNA URE OFAUTHORIZED AGENTOR DRIVER DATE . ROLL-OFFS FI-ATZED VAN D U <br /> a Q n <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 cOMPLMD BY LANDFILL) <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> O SOIL <br /> EMARKS <br /> Cs CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NOM-FRIABLE <br /> ASBESTOS <br /> SIGNATUAE OF AUTHORIZED AGENT DATE <br /> 0 WOOD <br /> 0 ASH <br /> l.? 4 1 ��:: O SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTOEXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE'SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> . j <br />