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', WARD NON-HADOUS WASTE MANIFEST <br />WASTE TMWMENT AND DISPOSAL FACILITY <br />451171.1V . JOB ACCEPTANCE N0. <br />GENERATOR .: .,___,: ,'. H <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />E.Z. SERXE OF CALIF <br />MAILING <br />❑GLOVES ❑GOGGLES ❑RESPIRATOR E] HARD HAT <br />ADDRESS <br />❑TY-VEK ]OTHER <br />P.O. SOX 922021 <br />CITY, STATE, ZIP <br />SPECIAL HANDLING PROCEDURES: <br />HOUSTON, TEXAS 77292-2021 ^ <br />PHONE <br />ON -4312 <br />CONTA�7R , ,. <br />R. JI.1 SHIFLET <br />SIGN T E OF AUTHORIZED AGENT / TITLEDATE <br />WASTE TYPE <br />RECEIVING FACILITY <br />❑ SLUDGE <br />TREATMENT SOIL <br />❑ NON -FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />❑ DISPOSAL SOIL <br />❑ WOOD <br />❑ CONSTRUCTION SOIL <br />❑ ASH <br />9999 SOUTH AUSTIN ROAD <br />• <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4.298 PHONE <br />GENERATING FACILITY <br />239 S. STOCKTOI! ST. <br />(209) 982-1009 FAX <br />RIPON, CA <br />NAME _ <br />NOTES: - TRUCK NUMBER <br />ADDRPJH HHAMILTON TRUCKING <br />I <br />• CITY,STA1`E, fOULINE AVE. <br />LOAD #5 <br />END DUMP BOTTOM DUMP TRANSFER <br />PHONE((9L'nnDggE1SDT77,ggCAgq195358 _ <br />SIGNATURE "U� O -Fa AILED <br />11 ❑ <br />- <br />AGENT OR DRIVER DATE <br />ROLL F(S) FLAT-BED . VAN DRUMS <br />El El 1:1 <br />FORWARD INC. LANDFILL <br />CUBIC YARDS <br />Forward shall have no obligation to accept the waste if weather or other <br />15 C. YDS <br />conditions impair the safe and effective disposal of the waste or if the waste <br />impairs the safe and effective operation of the Landfill. Forward shall use <br />DISPOSAL METHOD: '. (TO BE COMPLETED 8Y FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />-' DISPOSE . BIO AERATE STOCKPILE OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />weather or other site conditions, Forward shall notify the Disposer when site <br />SOIL <br />conditions are expected to change such that Forward will be able to accept <br />El SLUDGE <br />the waste. <br />REMARKS - <br />❑NON -FRIABLE <br />• _ <br />FACILITYTICKET NUMBER - -- <br />ASBESTOS <br />❑ WOOD <br />_ _ �,- <br />SIGNATUR OF AUTH RIZED A, NT DATE <br />- :. <br />❑ ASH <br />'.. <br />THER <br />SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO <br />EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE <br />SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST <br />BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL (209) 982-4298 <br />MANIFEST #14734 <br />