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- Keller Canyon atrl el I�vuby sl.. Forward <br /> � i Landfill t d�fil � 1' Landfill � <br /> 901 Bailey Read 01MYmLsat eoCd. 16Q1 Ixo Lerr g. Ioad 9993 S.Austin Egad t <br /> Pittsbug,GA 94565 Half Mdon Bay,CA 94919 Milpitas,CA 95035 Manteca,GA 95336 <br /> Phone(925)459-9800 Phone(650Y 725-1819 Phone 408)045-2800 Phone(209)'962-4293 i <br /> Fax(925) -8891 FAX(650)728.9.183 Fax( 9)262.2871 Fac(209)982-1089 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR <br /> I p WASTE ACCEPTAr CE,N(), <br /> MAtUNG ADDRESS <br /> a i <br /> nSi"A'TE ZIP REOUIRED PERSONAL PROTECTIVE <br /> GLOVES �GOGGLES C5 RESPIRATOR C3R 1 HARD HAT <br /> PHONE Q Tl Q OTHER <br /> it ty _ <br /> Gt3NTACT PERS0N SPECIAL HAaNDL,ING FRCCEDURESr <br /> SIGNATUf4E=OF-AUTHORtZELD AGEt4T L TITLE DATE r. <br /> _ � f <br /> CENFIAMRS GEWMICA•[M�t heMbq a fflf 3I at Ma abov a eta3 atrw tier fa nun <br /> wegta atr datsrNd��0 Pats 261 pr�tsg���ha�et�mi�cada'ai pula9 tsn prop�vtj <br /> ' 4'fesCrEhad,Ktfr;E314tast'�uf jrck�0+�ci�a�in4 3;l ln�7rrrp�C�wituiti frac iran � a^t ,s Sn atp�tSK, 4 r, ; ., _ <br /> ragutai t lANi?,M ttarwcale Iat A Erma sant rraEduaF a4 a pravhwslg ros4Natod hxxtaslaa®wnato t <br /> rt ectwrna' �+rDra at riasrr t«ta.ac a *arantonarttravas r�n�trea>aa�oas�at+ RECEIVING FACILITY <br /> � sse�xdarw®rwhh ghs <br /> -. requitama�tts bt sd GFp Fasr4 2G8 acrd�jrn taxa a h�r'�iCtaeM v+t�t<Ia as sip ay- � I <br /> � �1Q€'.Ft'tf'arT78r. <br /> a� <br /> WASTE TYPE <br /> D DISPOSAL SLODG15 <br /> 0 CONSTRUCTION Q WOOD � <br /> u i EE3I iS U OTHER <br /> CI SPECIAL WARTS, <br /> GENERATING FACILITY' i <br /> y <br /> i <br /> - I <br /> TRANSPORTER N0 CES: ;V0Hi&E UctNk NumaIrR TRUCK NUMBER <br /> a <br /> ADDRESS <br /> CITY STATE,ZIP <br /> #°HONE END DVMP BOTTOM DUMP TRANSFER <br /> s <br /> ' SIGNATURE O AU'CHORIZED AGENT OR DRIVER DATE AOLL-01RFS. Fi.AT-BE O VAN DRUMS ; <br /> _ i I <br /> CUBIC YARNS } 1 <br /> I hereby certify that the above named material has leen �. <br /> accepted and to the beat of:my knowledge the foregn)nq DISPOSAL METHC)D; (TD 8E COMPLETED By I AI� tE ) I <br /> Is true and accurate. <br /> DISPOSE OTHER <br /> REMARKS <br /> Q SOIL ; <br /> CONSTkU TION' <br /> FACILITY TICKET NUMBER OEBFt68 <br /> a I+IDN=FftCAI3E.tx <br /> .. ASBESTOS <br /> SIGNATURE.OFAUTHORIZED AGENT DATE <br /> 0WOOD= <br /> 0 ASH <br /> C S EC3AL OTHF <br /> SCHEDULING MUST BE MADE PRIORTO 3.00 P,M.-rHIS DAY PniORTo EXPECTED ARRIVAL*ANY UNSCHEDULED LOADS ARE SUBJECT t <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILYDELIVERIES MUST BE SCHEZOULED WITH THE LANDFILL THE DAY BEFORE. I <br /> MANIFEST# E <br /> SALES OOPY101748 <br />