Laserfiche WebLink
❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island ([A-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 /> 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 /> P2niis Gia&Ef6 tric <br /> MAILING ADDRESS <br /> 77 Be&Std,MA Ston 1334.x. 43 <br /> 1-4 <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Sar Frwkisw t'A 94120 U GLOVES U GOGGLES U RESPIRATOR U HARD HAT <br /> PHONE <br /> U TY-VEK U OTHER <br /> CONTACT PERSON <br /> Gra SPECIAL HANDLING PROCEDURES: <br /> RobettSIGNATURE OF AUTHORI ED AGENT/TITLE DATE <br /> 411b p 4- <br /> GENERATOR'S CERTIFICATION:I hereVy cykify that the above named material is not a Hazardous <br /> waste as defined by 40 CFR Part 261 or 2 of the California code of regulations;has been property <br /> ` described classified and packaged,andis in proper condition for transportation a-cording to applicable <br /> regulations pNWIrthe waste Is a treatment residue of a previously restricted hazardous waste <br /> subject to the Dgpoeal Restrictions,l certify and warrant that the waste Has been treated in RECEIVING FACILITY <br /> accordance wit}i_the requirements of 40 CFR Pan 268 and is no longer a Hazardous waste as defined by <br /> -x.40 CFR Par(261_ <br /> 4�4? WASTE;Ty.PE: <br /> SPOSAL U SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRISD OTHER <br /> O SPECIAL WASTE <br /> GENERATIN—GFACILL ";- <br /> 1 ATEIRaP <br /> NOTES` VE UCCO E-. ENUMBER TRUCK NUMBER <br /> �� 3e <br /> ADDRESS"' / , <br /> w1 "- <br /> 0 J-AMBtPS4E CvA t <br /> CITY,STATE,ZIP <br /> inr ;CA 95492 <br /> ` PHONE, END DUMP BOTTOM DUMP TRANSFER <br /> '.707 $38-140! ❑ ❑ <br /> t=� <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> 3 <br /> CUBIC YARDS <br /> 1. 1 hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing <br /> is true and accurate. DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> O 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# Q Q n 0 •� <br />