Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island Forward <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 /> 1 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 /> Pacific ckh' c <br /> K. MAILING ADDRESS i <br /> k '> r �t, op A "� <br /> 314 <br /> CITY„STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 8at!` 1ico'LA 94120 O GLOVES U GOGGLES U RESPIRATOR O HARD HAT <br /> PHONE <br /> 3 U TY-VEK U OTHER <br /> CONTACT PERSON <br /> Rcpt(3my SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> GENERATORS CERTIFICATION:I her ify that the above named material is not a hazardous <br /> waste as defined by40 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-cording 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 268 and is no longer a hazardous waste as defined by <br /> -:-.40 CFR Part 261. <br /> WASTE TYPE: <br /> p,ISPOSAL O SLUDGE <br /> LI C N LI WOOD <br /> Ll DEBRIS, U OTHER <br /> K dSPECIkL)fVASTE <br /> CENERA"AQCILITY <br /> tir n LATHROPNIL- <br /> NOTES: VEHICLE LICENSE NUMBEFt. '-zr '''TRUCK NUMBER` <br /> � f <br /> 82C>< Court <br /> CITY,STATE,ZIP <br /> WindwrCAA 95492 <br /> PHONE END IPUMP BOTTOM DUMP TRANSFER <br /> (707)838-1407 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> f ❑ ❑ ❑ ❑ <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 /> U SOIL <br /> REMARKS <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U 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 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 If 9 Q ing n 4 <br />