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] Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill #fi!li <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road it tic 0+ <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 /> i <br /> NON-HAZARDOUS WASTE MANIFEST <br /> :NERATOR <br /> I'a:,i c as E.w;,w c WASTE ACCEPTANCE NO. <br /> ULING ADDRESS <br /> 77 Fle le Street M-ail Code n24 Ar�v�— <br /> TY STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Sain-IONE CA 9�7 1?i) ❑GLOVES O GOGGLES 0 RESPIRATOR O HARD HAT I Ikllltt <br /> iij O TY-VEK ❑OTHER t <br /> )N O <br /> SPECIAL HANDLING PROCEDURES: <br /> 3NATURE OF AUT ORIZED AGENT/TITLE DATE <br /> AuffiPacific <br /> Ga AgettEl for <br /> Pacific GAS tfz Electric - <br /> ! <br /> >vutlle <br /> ENERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous <br /> 3ste as defined by 40 CFR Part 261 or title 22 of the Catifomia code of regulations,has been properly <br /> rscribed,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> gulations;AND,if ttx waate Is•treatment residue of s previously restricted hazardous waste 1 <br /> d*W to the Lard Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> 000rdance with the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 1 CFR Part 261. <br /> >STE TYPE i I�I�I�I <br /> ❑ <br /> ISPOSAL ❑SLUDGE i role <br /> CONSTRUCTION 0 WOOD <br /> 0 DEBRIS ❑OTHER <br /> 0 SPECIAL WASTE <br /> :NERATING FACILITY <br /> T" urrtivn Tienyuraiur i�ornic�n I - _'..� <br /> IAL RTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> IDRE ent3este 1 Tans nation Z p <br /> f <br /> _ 11_e*te.Ct <br /> 1Y,STATE,ZIP <br /> Vy-ind.qor, CA 95492 <br /> j dk t <br /> IONE END DUMP BOTTOM DUMP TRANSFER <br /> - ❑ ❑ I <br /> 3N A IV <br /> ORIZED AGENT OR DRER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑re-248 { <br /> r v lo—1-7 <br /> I , <br /> CUBIC YARDS <br /> I hereby certify that the above named material has been <br /> mccepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) ! <br /> is true and accurate. <br /> DISPOSE OTHER SISI <br /> MARKS o SOIL <br /> ❑CONSTRUCTION <br /> DEBRIS <br /> 'aILITY TICKET NUMBER <br /> ❑NON-FRIABLE <br /> � <br /> (NATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> U WOOD <br /> O ASH t <br /> O SPECIAL OTHER <br /> I . <br /> IULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT tl! <br /> FUSAL.UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE ZAY BEFORE. it♦�i`flkil <br /> GENERATOR COPY MANIFEST 1t 341927 } <br />