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❑ Keller;Canyon U ox Mountain LJ NeWDy Is,ana u rurwaru <br /> Sanitary Landfill SaMpry Landfill Sanitary LqWfill Landfill <br /> 901 Bailtay Road 123 an Mateo Road 1601 Dixon La Road 9999 S.Austin Road <br /> Pittsburgp CA 84565 Half Moon Bay,CA 94019 Milpitas,CA 950M 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 WASTE ACCEPTANCE NO. <br /> 7 ELEVEN <br /> MAILING ADDRESS _3406 <br /> P.O. BOX 711 <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> DALLAS TX..75221-0711 O GLOVES O GOGGLES O RESPIRATOR O HARD HAT <br /> PHONE <br /> 208-429- ®TY VEK O OTHER <br /> CONTACT PERSON <br /> T , T SPECIAL HANDLING PROCEDURES: <br /> JAFF SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATOR'S CERTIFICATION:I hereby certify that the aG4ve named material Is riot a hazardous <br /> waste as defined by 40 CFR Part 261 or Ofle 22 of the Califorola code of regulations,has been properly <br /> classified and packaged,and is In proper conditioli for transportation a-cordkV to applicable <br /> tons;AND,H the waste Is a treatment residue 6f A previously restricted hazardous waste <br /> euect o the Land Disposal Restrictions,I certify and warrant that the waste Pura been treated in RECEIVING FACILITY <br /> aexordandui with the requirements of 40 CFR Part 266 and is no longer a hazardous waste as defined by <br /> 40 CFR Part 261. <br /> WASTE TYPE: <br /> O DISPOSAL O SLUDGE <br /> O CONSTRUCTION ®WOOD <br /> O DEBRIS O OTHER <br /> O SPECIAL WASTE <br /> GENERATING FACILITY <br /> 7 EIEVEN#32262 2360 GRAN I LINE RD I KAUY GA . <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER-1 <br /> TRUCKJNG,INC. �! <br /> ADDRESS <br /> 9-131 GERBER ROAD6()6�3q <br /> CITY,STATE,ZIP <br /> SACRAMENTO.CA 95829 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 916-689-4464 ❑ ❑ <br /> SIGNAT!JR AUTH RIZED AGENT OR DRIVER DATE ROL FF S FLAT-BED VAN DRUMS <br /> x, f <br /> CUBIC YARDS <br /> 18 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 /> O SOIL <br /> REMARKS ' <br /> O CONSTRUCTION r <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT , <br /> O WOOD <br /> O ASH <br /> O 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 /> TRANSPORTER COPY MANIFEST#226341 <br />