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FORWARD I - - , NON-HAZARDOUS WASTE MANIFEST <br /> INC OR <br /> P O R A T ED _ WASTE TREATMENT AND DISPOSAL FACILITY <br /> - ; JOBIACCEPTANCE NO. . <br /> GENERATOR _ -"_ _ __ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Nel.son_feady tax_;�� �,- � _T __ ";__ ❑GLOVES'QGOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK t ❑OTHER <br /> P.O. BOX 29_____ -- -- - _ -- - - -- SPECIAL HANDLING PROCEDURES <br /> CITY,STATE, 77--- <br /> K _ <br /> • tiponr CA-95366 <br /> PHONE <br /> 209-466-2884__ <br /> CONTACT PERSON - <br /> RussMelson <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE-- __ DATE <br /> WASTE TYPE - -- _-- - _ -- _-_ - _ _ RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS • FORWARD INC LANDFILL <br /> • ER DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> _GENERATING FACILITY - - Y T _ -_ (209) 982-4298 PHONE <br /> Nelson Ready mix Concrete Plant (2 0 9) 982-1009 FAX 4 '- <br /> 22700 S. Hwy 99 - - <br /> Ripon, CA 95366 <br /> I NAME • " NOTES TRUCK <br /> Rich Hamilton Trucking_...�_____- _-- <br /> ADDRESS <br /> 1217 S. 7th Street <br /> • CITY,STATE,ZIP <br /> ' 9361 <br /> - END DUMP BOTTOM DUMP - TRANSFER <br /> PHONE _ _ -_ _ _ _ <br /> 209-578-4100 __ " _ _ _ _ _ _ _ _ _ - ❑ - ❑ - -- <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN_- DRUMS' " <br /> - - -- - - - - - - - -- - - -- s 8--11-99 - - - -❑ �' E]- - -❑ ' <br /> FORWARD INC. LANDFILL CUBIC YARDS] <br /> Forward shall have no obligation to accept the waste it weather or other <br /> conditions impair.the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO- AERATE_STMIMLE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions,Forward shall notify the Disposer when site OIL <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste _ _ ❑ SLUDGE <br /> • REMARKS -___. __ _ __�T_-_____ ---._ .,-- w—_ � _ _ - a <br /> -- -- — NON-FRIABLE <br /> -- - -- _ w — _ - _ _- - ❑ ASBESTOS - <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE EBF AUTHORI2I AGENT [TATE a - - - <br /> - - - --- Q ASH <br /> 7NC ' r - I ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THEDAYBEFORE <br /> TO SCHEDULE CALL (209)982-4298 " MANIFEST# 76560 <br /> GENERATOR COPY <br />