Laserfiche WebLink
r l.andfiii ars' Landfill iii <br /> nyon E] Ox Mountain Newby Island Forward <br /> Landfill <br /> • iley Road 12310 San Mateo Road 1�1 Dixon Landing Road 9999 S.Austin Road <br /> r.-Manteca,CA 533 <br /> burg,CA 94 Half n y,CA 94019 Milpitas,CA 95035 2 2 <br /> Phone(925)458- Phone( )726-1819 <br /> Phone(4 j 2 -1 <br /> Fax(925)4 -9891 Fax( 0)726-9183 Fax( )262-2871 �hone <br /> ,+`( j <br /> NON-HAZARDOUS WASTE MANIFEST <br /> GENERATOR WASTE ACCEPTANCE NO. <br /> AILING ADDRESS <br /> `)Lt ° ` REQUIRED PERS AL PROTECTIVE E UIP <br /> CITY,STATE,ZIP <br /> GLOVES ❑GOGGLES O RESPIRATOR ® RD-HAT <br /> PHONE � . _ . <br /> ❑TY VE ❑OTHER <br /> €L <br /> CONTACT PERSON SPECIAL HANDLING PROCEDURES: <br /> S AUTHORIZED AGENT!TITLE DATE <br /> d , 'XtL' Q <br /> GENEWORS CERTI TSN:I a <br /> hazendots <br /> waste as defined by 40 CFR Part 261 or We 22 of the Card0mia Gods d .ons,has a e <br /> en property <br /> described,classified and peckagecL and is in proper condition for transportation <br /> -zording to applicable <br /> AND it is m tntstment reekka of° <br /> te R i <br /> RECEIVING FACILITY <br /> r of 40 CFR ftrt M and is no a hazardous waste as defined by <br /> AO CFR PaR 261. <br /> ASTE PE: <br /> ®DISPOSAL U SLUDGE <br /> STRUCTION ❑WOOD <br /> U DEBRIS ®OTHER <br /> ®SPECIAL WASTE <br /> GENERATING FACILITY <br /> o 1 ,<' t fah°i. <br /> 'TRANSPORTER NOTES: VEHICLE NUMBER I I tjUt; NUMBER <br /> _,.. <br /> A <br /> CITY,"STATE,-ZIP <br /> '-; BOTTOMDUMP SFE <br /> PHONE <br /> END DUMP <br /> Sl A ORIZED AG O DRIVER DATE R S} ED UMS <br /> B <br /> CUBIC YARDS <br /> F' <br /> I hereby certifythat tabove named material has been <br /> acceptedthe best of my knowledge ®in DISPOSAL : (TO BE COMPLETED BY FILL) <br /> is <br /> DISPOSE OTHER_ <br /> IL <br /> E A KS U CONSTRUCTION <br /> DEBRIS <br /> FACILITY TICKET NUMBER 0 NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> j U WOOD <br /> f t i <br /> GASH <br /> / ❑SPECT O E <br /> --- EDULED LOADS ARE SUBJECT <br /> SCHEDULINGtOR70 3:00 P.M.THE DAY PRIORTEXPECTED ARRIVAL*ANY UNSCH <br /> _.._.- -- -._�.-._. �...®...®... ®....o w..a ea®waan•n aa®® mv- ot%umns 11 cn C 1 amnFil I T14F n" RFFORP. <br />