Laserfiche WebLink
U rcener canyon LJ Ux Mountain U Newby Island -forward <br /> Sanitarylandfill 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 /> M <br /> CT <br /> GENERATOR WASTE ACCEPTANCE NO.c <br /> AILING ADDRESS <br /> itci <br /> .rte Beal.� a I.r6e ail t^,69'e�.r 2�r%t. <br /> IY, STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PHONE U GLOVES U GOGGLES U RESPIRATOR U HARD HAT <br /> '' -5 223-1 <br /> 7 <br /> 71:4 UTY-VEK UOTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> 4uthlorl>.t<td of <br /> 4,.rr 'f ................... <br /> J'f: �teJf4� <br /> GENERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been properly <br /> described,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> regulations;AND,If 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 Part 261. <br /> WASTE TYPE: <br /> U DISPOSAL U SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRIS U OTHER <br /> Cl SPECIAL WASTE <br /> GENERATING FACILITY <br /> YJsttiorin OArtyrW4 <br /> Zf`.• <br /> i TRANSPORTER c NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> E{iI¢: egtt z 4 t13r�?IF�F t.i$ fidii F- <br /> ADDRESS <br /> CITY, STATE, ZIP <br /> Wim,dsojr, CA 95492 <br /> PHONEEND DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED gGENT OR;DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> r� 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 <br /> REMARKS U SOIL <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> SIGNATURE OF AUTHORIZED AGENT DATE ASBESTOS <br /> U WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO 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# 1 rl f <br />