Laserfiche WebLink
U Keller Canyon U Ux Mountain U Newby Islana �U/F orwarcl <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 /> Pacific GM&Ek-ctrk <br /> {z MAILING ADDRESS <br /> Beale.77 Weet,NW 6 - <br /> CITY,STATE,ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> S.'iiiFisisco'Csa 94120 <br /> PHONE D GLOVES ❑GOGGLES U RESPIRATOR U HARD HAT <br /> 1 -a O TY-VEK O OTHER <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> Ro Gmy <br /> SIGNATURE OF AUT RIZED AGENT/TITLEI DATE <br /> GENERATOR'$.CERTIFICATION:I hereby cediy that the above named material is not a hazardous <br /> SF waste as dbfined by 40 CFR Part 261 or title 22 of the Califomia code of regulations,has been property <br /> describO,;c1assiw and packaged,and is in proper condition for transportation a-cording to applicable <br /> regula", r AND,If the waste Is a treatment residue of a prevlously restricted hazardous waste <br /> subled to Me Card 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-Pari261. - <br /> 3 WASTE TYPE: <br /> ISPOSAL. U SLUDGE <br /> O'CONSTRUCTION U WOOD <br /> E" O DEBRIS U OTHER <br /> D SP' C AL.WASTE <br /> GENERATING FACILITY <br /> �. k.attpro fNOst cco� LA'f HROP <br /> kss <br /> _ 4 <br /> ' iADDRESS. .' <br /> 82033 .-W Cowl <br /> 'C <br /> ITY,_STATE;ZIP <br /> Wi4*0r,CA:95492 <br /> r PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ;07)838-1407 ❑ ❑ <br /> SIGNATURE 13 IZED 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 <br /> IS true and accurate.is <br /> METHOD: (TO BE COMPLETED BY LANDFILL) <br /> DISPOSE OTHER <br /> U <br /> EMARKS SOIL <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 /> GENERATGR COPY MANIFEST# 2890620 <br />