Laserfiche WebLink
�w r -- <br /> [D,-','eller Canyon ❑ MR Mountain Newby Island °•❑Forward , <br /> Sani,tw y Laddfill t Sanitary Landfill Sanitary Landfill r Candfiil <br /> 901 Bailey Road 12310 San Mateo Road 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) 982-429 <br /> Fax (925) 458-9891 Fax(650) 726-9183 Fax(408) 262-2871 Fax(209) 982.1 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR <br /> - fir' i°• s WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS r„ <br /> r' C- L z o,, 'Y 'r— <br /> CITY, <br /> CITY, STATE, ZIP- REQUIREC? PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE U GLOVES ❑GOGGLES 0 RESPIRATOR U HARD HAT <br /> CONTACT PERSON <br /> d TY-VEK ❑OTHER <br /> _ r -, _ _ _ <br /> SPECIAL HANDLING PROCEDURES <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE ` <br /> r <br /> GENERATdFt S CERTIFICATIdN I hereby certify that the above Hamad malarial is nota hazardous <br /> wa4te as defined by 4Q CFR Part 281 Dr 4tlo 22 01 the Catrtomla code of regulaiwns has been properly <br /> described classihod and packaged and is m proper cortdibon forlransportation a^cording Io appircabie <br /> regulations ANU ff thea weals Is a trpetmeM residua of a previously nestrk ted hererdous waste <br /> aubJectla the[and pisposal Resinetsons I candy end warrant that the waste has bean traated in '"4 <br /> te As defined by RECEIVING FACILITY <br /> accordance with the requirements of 4C CFR Pari 26tt and is na longer a hazardous was <br /> 40 CFR Pari 261 <br /> WASTE TYPE <br /> O DISPOSAL U SLUDGE <br /> 0 CONSTRUCTION U WOOD " <br /> U DEBRIS Q-0THER <br /> U SPECIAL WASTE -•.,_� <br /> GENERATING FACILITY _ <br /> 7 ,41 A/ <br /> TRANSPORTER ) NOTES VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE,ZIP <br /> PHONE T= — '- --T- =T_ -T--- END DAMP BOTTOM DUMP T TRANSFI,B_ } <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been _ <br /> accepted and to the best of my kndwiddge the foregoing <br /> is true and accurate. DISPOSAL METHOD (TO 8E COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> EMARKS Q SOIL ' <br /> 0 CONSTRUCTION <br /> FACILETY TICKET NUMBER . 'r DEBRIS <br /> U NON-FRIABLE ' <br /> + f tASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT f E <br /> WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> 100 119 <br /> ` SCHEDULING MUST BE MADE PRIOR TO 3 00 P M THE DAY PRIORTO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUIMj ECT' <br /> ' TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL, THE DAY BEFORE <br /> kAeN1C=Q'r 4s A `Z CC 12 <br />