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WARD NON HA&FDOUS WASTE MANIFEST <br />WASTE TI1WMENT <br />AND DISPOSAL FACILITY <br />Nom' A <br />JOB ACCEPTANCE N0. <br />GENERATOR <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />E.Z. SERVE OF.. CALIF• <br />❑GLOVES ❑GOGGLES ❑RESPIRATOR []H ARID HAT <br />MAILING ADDRESS <br />❑TY-VEK [-]OTHER <br />P.O. BOX _922021 _.. <br />CITY, STATE, ZIP <br />SPECIAL HANDLING PROCEDURES: <br />• HOUSTON, TEXAS 77292-2021 <br />• PHONE ,_... ._...... <br />3l 684-4312 <br />CONT T ERSON." <br />Mi JI^I SHIFLET <br />SIG T E OF AUTHORIZED AGENT / TITLE DATE <br />} <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) 982-4298 PHONE <br />GENERATING FACILITY <br />239 S. STOCKTON ST. <br />(20/9) 982-1009 FAX <br />RIPON, CA <br />NAME <br />NOTES: TRUCK NUMBER <br />RICH HAMILTON TRUCKING <br />ADDRESS <br />455,D <br />1336 PAULINE AVE. <br />LOAD 99 <br />• CITY, STATE, ZIP <br />MODESTO,CA 95358 <br />PHONE <br />END DUMP BOTTOM DUMP TRANSFER <br />(209) 578-4100 <br />-O❑ <br />SIGNATURE OF ALLTHORIZ�DI AGENT OR DRIVER DATE <br />ROLLOFF(S) FLAT-BEDVAN DRUMS <br />El <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 BY FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />-. DISPOSE -.BIO AERATE OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />ISTOCKPILE1, <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 />❑ SLUDGE <br />the waste. <br />• <br />REMARKS <br />❑ NON-FRIABLE <br />FACILITY TICKET NUMBER - , . <br />ASBESTOS <br />❑ WOOD <br />SIGNATORE-QF'AUTH& IZE_D AGET „ DATE _ _ <br />/ /I/fit <br />❑ ASH <br />❑ OTHER <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 # 14738 <br />