Laserfiche WebLink
14elle _ [J Ox N#ountain ❑ Newby Island ;Forward <br /> Sanita n 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 /> GENERATOR WASTE ACCEPTANCE NO. <br /> AILING ADDRESS <br /> 77 <br /> �Beale Str=t Mail Code IR24A <br /> �v�— <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> S.-an Frac-cisco CA 94120 U GLOVES U GOGGLES U RESPIRATOR U HARD HAT <br /> PHONE <br /> ❑TY-VEK U OTHER <br /> CONT CT ERSON <br /> SPECIAL HANDLING PROCEDURES: <br /> SIGNAT RE OF AUTHORIZED AGENT/TITLE DATE <br /> /, Authorized Aget t fnr <br /> Pfi Gee& ~+let tric INO...,.. <br /> GENERATOR'S CERTIFICATION:I hereby certify that the above named material is not a/hazardous (7( <br /> waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> described,classified and packaged,and is in proper condition for transportation a-,=ding to applicable <br /> regulations;AND,N the waste Is a treatment residue of a previously restricted hazardous waste <br /> subject to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance with the requirements of 40 CFR Part 266 and is no longer a hazardous waste as defined by <br /> 40 CFR Pan 261. <br /> WAS,TE TYPE: <br /> ISPOSAL O SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRIS U OTHER <br /> U SPECIAL WASTE <br /> GENERATING FACILITY <br /> aomlcm Dehycdraior i-ftcrrni.Un <br /> TRANSPORTER NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> este I ransportatiort �( r <br /> ADDRESS <br /> CITY,STATE,ZIP <br /> '%� 9549'2 <br /> PHONE END DUMP EOTTQM DUMP `:'TRANSFER <br /> t*7f171R1R_1A07 ❑ --I- <br /> SIGNATURE <br /> SIGNA UR OF UTHORIZED 6GENT OR DRIVER DATE ROLL-OFF(S) FLAT=BFDy VAN DR MS <br /> CUBIC YARDS <br /> I hereby certify that the above named material 7be�enaccepted and to the best of my knowledge the DISPOSAL METHOD: ATO BE COMPLETED BY LANDFILL) <br /> is true and accurate. <br /> DISPOSE OTHER <br /> U SOIL <br /> EMARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> U WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIO,ATO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL,UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL,THE DAY BEFORE. <br /> GENERATOR COPY MANIFEST# 341955 <br />