Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island Q( Forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill t Landfill <br /> 901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsbbrg,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 /> -fti.fic Gas&Electne <br /> MAILING ADDRESS <br /> 4314 <br /> ealeStwk Mail 77 <br /> Stop B24A <br /> CITY;STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> SM E 'C` 420 O GLOVES 0 GOGGLES 0 RESPIRATOR 0 HARD HAT <br /> PHONE <br /> (415)9773.3773 0 TY-VEK O OTHER <br /> CONTACT PERSON <br /> ' R SPECIAL HANDLING PROCEDURES: <br /> sy <br /> SIGNATURE OF AUTHORIZED AGEA, /TITLJE I DATE]�G� <br /> .GENERATOR'S CERTIFICATION:I hereby certify that the above named material is not a hazardous - <br /> wasie 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-,r"ding to applicable <br /> regulafi_ons NWH the waste Is a treatment residue of a previously restricted hazardous waste <br /> a Disposal Restrictions,I certify grid warrant that the waste has been treated in RECEIVING FACILITY <br /> Nodi tf a requirements of 40.CFR Part 2 no longer a hazardous waste as defined by <br /> 40 CFR Part 261.,= <br /> WASTE TYPE: <br /> DISPOSAL O SLUDGE <br /> O CONSTRUCTION O WOOD <br /> U DEBRIS O OTHER <br /> 1O SPECIAL WASTE <br /> VEFIATINGFACILITY <br /> b'`tFaAictla LAT MOP <br /> :r <br /> NOTES: VEHIC;L€' ISE NUAAfER TRUCK NUMBER" <br /> 1. <br /> DORESS <br /> a'D�m�Caeut . <br /> -I;TY:STATE;ZIP <br /> 31V ,CA:95492' <br /> iPHONE END DUMP BOTTOM DUMP' TRANSFER <br /> 833-I4i17 ❑ ❑ <br /> IGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> 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 /> ■ <br /> DISPOSE OTHER • <br /> REMARKS O SOIL <br /> 0 CONSTRUCTION •' <br /> :FACILITY TICKET NUMBER DEBRIS <br /> ❑NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> Cl WOOD <br /> 0 ASH <br /> 0 SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 3:00 P.M.THE DAY PRIOR TO EXPECTED ARRIVAL a 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# 0 0 17 C O C <br />