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] Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road ii fG I <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)982-4298 j <br /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209) 982-1009 i <br /> NON-HAZARDOUS WASTE MANIFEST <br /> :NERATOR WASTE ACCEPTANCE NO. <br /> Pacific Clar, & lcctric <br /> ULING ADDRESS <br /> 77 Beale Street 4�CS— <br /> rY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> San Fraincisoo ( A 943.7U ❑GLOVES ❑GOGGLES O RESPIRATOR 0 HARD HAT <br /> IONS i I <br /> - - - ❑TY-VEK OOTHER � t <br /> )N TA CT P ERSO I <br /> SPECIAL HANDLING PROCEDURES: <br /> 3NATURE OF AUTHORIZED AGENT/TITLE DATE <br /> Attdtorized Aged for <br /> Pacific Gas&P.lechic ............ <br /> �— j i�t7liiZ I . <br /> BATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous <br /> isle as defined by 40 CFR Part 261 or fide 22 of the California code of regulations,has been property <br /> isc ribed,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> gulabons;AND,If the waste Is a treatment residue of a previously restricted hazardous waste <br /> tbjecl to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> xordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 1 CFR Part 261. <br /> kSTE TYPE: ! t <br /> DISPOSAL 0 SLUDGE fl g 0 <br /> 0 CONSTRUCTION 0 WOOD j <br /> O DEBRIS 0 OTHER <br /> O SPECIAL WASTE <br /> NERATING FACILITY <br /> rnicrn V01tVUrdi0r .1 nomton <br /> IAfti..,-ORTER NOTES: VEHICLE CENSE NUMBER TRUCK NUMBER <br /> ; . <br /> 0enB <br /> tate l rartsportatZon <br /> (DRESS <br /> _ _ este t / I <br /> rY,STATE,ZIP _ <br /> Wini1gor, CA 1 t04 <br /> IONE END DUMP BOTTOM DUMP TRAN(707)83lFtl `1 <br /> L) L)3N A RIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN 'DRUMS <br /> -� ❑ ❑ ❑ ❑ <br /> CUBIC 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 tk#0 <br /> 0 SOIL <br /> :MARKS <br /> O CONSTRUCTION <br /> CILITY TICKET NUMBER DEBRIS r <br /> 0 NON-FRIABLE <br /> '3NATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> 0 WOOD i <br /> 0 ASH <br /> 0 SPECIAL OTHER <br /> )ULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT ) ; <br /> :IFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> GENERATOR COPY MANIFEST N 341917 <br />