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)7267'1819 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 /> Pacific as&E <br /> MAILING,ADDRESS <br /> 4A <br /> CITY STATE,ZIP. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> tRr 'CA94f20 0 GLOVES 0 GOGGLES 0 RESPIRATOR 0 HARD HAT <br /> PHONE <br /> 0 TY-VEK 0 OTHER <br /> CONTACT PERSON <br /> .i <br /> Robeit Gray SPECIAL HANDLING PROCEDURES: <br /> 5^ SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> f NO/J ' <br /> GENERATORS CERTIFICATION:I hereby that the above named material is not a hazardous <br /> waste as defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> described dassitled and packaged,and is in proper condition for transportation a-cording to applicable <br /> regWaf3ona AND if the waste Is a treatment residue of a previously restricted hazardous waste <br /> b the fiarid Disgosal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> lance,Wd�f fequirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> 40 CFR Part261 <br /> WASTE TYPE: <br /> J2FbISPOSAL O SLUDGE <br /> O CONSTRUCTION 0 WOOD <br /> =� 0 DEBRIS O OTHER <br /> 0 SPECIAL WASTE_. <br /> GENERATINGFAGIL IT! <br /> P �5�tion L..NTHROP <br /> NOTES: VEHICLE LICENSE NUMBER TRUCK NUMBER <br /> & <br /> ;b ecixm't <br /> CITY,STATE,ZIP <br /> W",C A 9 5493 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> :(707)838-1407 ❑ ❑ <br /> SIGNATURE`OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN RUMS <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 /> ❑ <br /> EMARKS SOIL <br /> O CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> O NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> 0 WOOD ' <br /> t <br /> 0 ASH l <br /> 0 SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO 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# 9 Q Q r,n i <br />