Laserfiche WebLink
U Keller Canyon U Ox Mountain Ll Newby Island H-ftrward <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 /> GENERATOR WASTE ACCEPTANCE NO. <br /> .c &Ei_-ctric <br /> MAILING ADDRESS <br /> r --&IeStreet,Mail <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Sett test`sro,C i 941,410 <br /> PHONEO GLOVES Q GOGGLES Q RESPIRATOR 0 HARD HAT <br /> " <br /> r i-s Q TY-VEK Q OTHER <br /> CONTACT PERSON <br /> Rpt Gray SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZ D AGENT/TITLE DATE r�o� <br /> 15 'e <br /> y� <br /> GENERATOR'S CERTIFICATION:I her y fy that the above named material is not a hazardous <br /> JVaste as defined by 40 CFR Part 261 or a of the California code of regulations,has been properly <br /> -'Frt described.ciassirred and_p"aged,and is in proper condition for transportation a-:cording to applicable <br /> ""regulations;AND,If tie 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 46 CFR Part 268 and is no longer a hazardous waste as defined by: - <br /> 540'CFR Part 261: - <br /> k <br /> ftTE TYPE: <br /> ISPOS.AL 0 SLUDGE <br /> e CONSTRUCTION Q WOOD <br /> O DEBRIS ❑OTHER <br /> Q`SC�ECIAL WASTE <br /> GENERATING FACILITY <br /> ,I =1 I� yt r tar Stem I:r1THROP <br /> mile" <br /> ;,. <br /> RANSPORTER RTES:"'(/E� "T R <br /> 3 5te.Truz PIDYI- <br /> CITY-STATE;ZIP �� <br /> ldttC)t, A <br /> 5492 <br /> PHONE <br /> END DUMP BOTTOM DUMP TRANSFER.. <br /> 1407 LI <br /> <ti SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> 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 /> Q SOIL <br /> EMARKS <br /> Q CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> Q NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> Q WOOD <br /> ` Q ASH <br /> Q 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# 2 8 9 0^7 E <br />