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u Keller canyon U vx mountain u New®y ts,anu u rurwatu <br /> Sanitary Landfill Sa ary Landfill Sanitary La dfIII Landfill <br /> 901 'Bailey,Road- 123 an Mateo Road 1601 Dixon La Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Half Woon Bay,CA 94019 Milpitas,CA 95 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(C-60)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NONHAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> 40g <br /> CITY, TA E,ZIP REQUIRED PERSONAL P OTE TIV E UIPME T <br /> ?� 0 GLOVES 0 GOGGLES 0 RESPIRATOR 0 HARD HAT <br /> P <br /> 0 TY VEK ❑OTHER <br /> C A ON <br /> SPECIAL HANDLING PROCEDURES: <br /> SI I / DATE <br /> GENERATOR'S CERTIFICATION:I hereby certify that the above named tectal is not a hazardous <br /> waste as defined by 40 CFR Part 261 or tide 22 of the California code ut dl ,has been property <br /> described,classified and ,and is in proper condition for tram a^cording to applicable <br /> eaqpuulatiorm;AND,M the wast,Is•treabn®nt residue of a previously restricted hazardous waste <br /> eubJect to the L.artd Diaposal Restrktions,l certify and warrant that the waste has been treated In RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 266 and is no longer a hazardous waste as defined b1 <br /> 40 CFR Part 261. <br /> WASTE TYPE: <br /> 0 DISPOSAL 0 SLUDGE <br /> 0 CONSTRUCTION O WOOD <br /> 0 DEBRIS 0 OTHER <br /> 0 SPECIAL WASTE <br /> GENERATING FACILITY <br /> 7 ELEVEN#32262 ' 2360 GRANTLINE RD TRACY CA . <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> JIM A MANI EY TRUCKING, INC 91 "1 <br /> ADDRESS A <br /> ,CITY,STATE,ZIP <br /> QAe CA 95829 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> S1 AUTHORIZED AGENT OR DRIVER DATE RO -OFFS FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been 18 YARDS <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 /> ®SOIL <br /> REMARKS <br /> CONSTRUCTION <br /> FACILITY TICKET Y I LIMBER DEBRIS <br /> s 0 NON-FRIABLE <br /> s ASBESTOS <br /> SIGNATURE OF AWH94lg&D AGENT DATE <br /> O WOOD <br /> 1 <br /> t % , 0 ASH <br /> 1 O SPECIAL OTHER <br /> SCHEDULING MUST B ADE PRIORTO 3:00 P M.THEPRIIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON IVAL. ONGOING.DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE,�DAY BEFORE; <br /> TRANSS.PRTER COPY MANIFEST#2 G <br />