Laserfiche WebLink
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 <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 <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. <br /> p t!t tl9t t <br /> �auutC Via$ ,fi i ccu u <br /> ►ILING ADDRESS <br /> nnnn— ; <br /> 77 RQa1P Strut bAail Code BUA <br /> rY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> S Fran riwrn CA 94170 U GLOVES U GOGGLES U RESPIRATOR O HARD HAT <br /> I <br /> !ONE <br /> U TY-VEK U OTHER <br /> INT R IR obea- rav SPECIAL HANDLING PROCEDURES: 1 <br /> aNATURE OF AUTIJORIZED AGENT/TITLE DATE <br /> Auffioriud ASt at for <br /> t Pacific Claw&Electric f }� <br /> *OttI <br /> ]JERATOR'S CERTIFICATION:1 hereby certify that the above named material is not a hazardous 1�1l111C j <br /> tate as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> scribed,classified and packaged,ands <br /> in proper condition for transportation a-cording to applicable <br /> pulations;AND,If the waste 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 /> cordance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 1 CFR Part 261. <br /> 1STE TYPE: l <br /> ISPOSAL 0 SLUDGE <br /> CONSTRUCTION U WOOD <br /> O DEBRIS U OTHER <br /> 0 SPECIAL WASTE <br /> :NERATING FACILITY <br /> i ncrrn.iun r-m>ityurator i nuln.icnt I <br /> Al 3RTER NOTES: VEHICLE LICENSE NUM8tki TRUCK NUMBER <br /> !ae <br /> DRESS �> <br /> 920 De-m-ate _t_ <br /> fY,STATE,ZIP p. <br /> Windsiff <br /> CA 95492 <br /> ONE END DUMP BOTTOM DUMP TRANSFER <br /> R ❑ ❑ L. <br /> iNA U F AUT IZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> %5o ❑ ❑ ❑ ❑ <br /> 1►t:lIl <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 <br /> is true and accurate. DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> I <br /> DISPOSE OTHER <br /> i <br /> MARKS U SOIL <br /> U CONSTRUCTION <br /> DILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS I , <br /> I'NATURE OF AUTHORIZED AGENT DATE j tl 1 <br /> O WOOD I <br /> 0 ASH J <br /> I <br /> 0 SPECIAL OTHER <br /> )ULING MUST BE MADE PRIORTO 3.00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SUBJECT , <br /> :fUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> GENERATOR COPY MANIFEST M 34 926 � � <br />