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--- " --- -_••••,••�••••• 1..__l 1`4aviruy 1siana LJ I-Orwarcl <br /> Sanitary Landfill knitary Landfill Sanitary&ndfill Landfill <br /> 901 Bailey Road19999 0 San Mateo Road 1601 Dixo nding Road <br /> Pittsburg,CA 94565 half Moon Bay, CA 94019 Milpitas,CA 95035 S Austin Road <br /> Phone(925)458-9800 Phone(650) 726-1819 Phone 408 945-2800 Manteca,CA 95336 <br /> Fax(925)418-9891 Fax(650)726-9183 Fax 408)262-2871 Phone(209)982-4298 <br /> ( Fax(209) 982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR <br /> 7 ELEVEN—— WASTE ACCEPTANCE NO. <br /> MAILING ADDRESS <br /> -3406 <br /> CITY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE- EQUIPMENT <br /> nAI I AS TY � � � <br /> PHONE O GLOVES O GOGGLES U RESPIRATOR U HARD HAT <br /> C A PE ON U TY VEK U OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNATUMOCiP I I �b A / L r DATE <br /> GENERATOR's CERTIFICATION:I hereby certify that the above ed material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or Gtle 22 of the Californiaa of regulations,has been properly <br /> described,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> lationa;AND,H the waste Is a treatment residue of a previously restricted hazardous waste <br /> and <br /> accordance wto the 1 h the rend quirrements osal of 40 CFR Pions,I art 268 and isnolonger a hazardouwaste has s <br /> watreated <br /> eaas defined by <br /> 40 CFR Part 261. RECEIVING FACILITY <br /> WASTE TYPE: <br /> Q DISPOSAL Q SLUDGE <br /> Q CONSTRUCTION Q WOOD <br /> Q DEBRIS Q OTHER <br /> Q SPECIAL WASTE <br /> GENERATING FACILITY <br /> 7 ELEVEN#32262 2360 GRANTLINE RD TRACY CA . <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBERTRUCK NUMBER <br /> ADDRESS AN EY T UCKiNG INC. �E 7 \ <br /> CIN, STATE,ZIP <br /> PHONE A �,A <br /> END UMP BOTTOM DUMP TRANSFER <br /> SI N T E AUTHORIZED AGENT OR DRIVER DATE <br /> ROL -O FS FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> 1 hereby certify that the above named material has been 18 YARDS <br /> accepted and to the best of my,knowledge the foregoing <br /> is true and accurate. DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL <br /> DISPOSE OTHER <br /> �.<.. <br /> EMARKS U SOIL <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS i t, - <br /> Q NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED AGENTATE ASBESTOS <br /> U WOOD <br /> Q ASH <br /> Q SPECIAL OTH`FR <br /> SCHEDULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIORTO . _.ECTED ARRIVAL*ANY UNSCHEDULED LOADS ARE S <br /> -ATO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUS1,O)BE SCHEDUI PD WITH THi G�!►I OFILL THE DAY.'BEBJ <br /> FECT <br /> O <br /> zi TRANSPORTER COPY MQl� T# 8 <br />