Laserfiche WebLink
J Keller Canyon ❑ Ox Mountain ❑ Newby Island fia'Forward j <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg,CA 94565 Halt 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 <br /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> :NERATOR WASTE ACCEPTANCE NO.JL <br /> V <br /> acifc Gas cx. A11CVLt1V <br /> AILING ADDRESS <br /> Anon- <br /> 77 Beale Street Mail Code B24 A <br /> 17Y, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> mi Francisco. CA ry?12Q <br /> IONEU GLOVES U GOGGLES U RESPIRATOR 0 HARD HAT <br /> - - -- U TY-VEK O OTHER j <br /> )NTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> Robert Cimy I <br /> 3NA,TURE OF AUTHORIZED AGENT/TITLE DATE <br /> AiDed Agent fur <br /> La-�� r__ <br /> vAT IliNffl <br /> NERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous 1rUlll <br /> 1510 as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been properly <br /> scribed,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> guletbns;AND,if ttrc weals is a treatment residue of a previously restricted hazardous waste <br /> bject to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> oordance with Bre requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 1 CFR Part 261. <br /> \STE TYPE: <br /> DISPOSAL U SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRIS U OTHER <br /> O SPECIAL WASTE <br /> :NERATING FACILITY <br /> i <br /> nornion iunyurmor muton a <br /> Ah. JRTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> LjonBeste 'l1wisportatton <br /> (DRESS <br /> 820 hep oste ;t_ I <br /> fY,STATE,ZIP <br /> Wintlqm- CA 95492 <br /> IONE END DUMP BOTTOM DUMP TRANSFER j . .. .. <br /> 7 'A - A7 ❑ ❑ I �: <br /> aN UR OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN 13RUMS <br /> ❑ ❑�Ls V:�_ I(I A)au <br /> ❑ ❑ 1 <br /> CUBIC YARDS <br /> I 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 /> U SOIL <br /> ARKS <br /> U CONSTRUCTION <br /> CILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> aNATURE OF AUTHORIZED AGENT DATE d I Illi <br /> U WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> )ULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIOR TO EXPECTED)AFIRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT <br /> :FUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHODULED WITH THE LANDFILL THE DAY BEFORE. <br /> GENERATOR COPY MANIFEST# 341918 <br />