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WARD NON-HA, �DOUS WASTE MANIFEST <br /> WASTE TRMIVIENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. CMM — 4074 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EOUIt? 46 <br /> KOA KAMPGROUNDS ❑GLOVES [:I GOGGLES E]RESPIRATOR ❑HARD HIT, , <br /> MAILING ADDRESS ❑TY-VEK []OTHER <br /> 2851 E . EIGHT ROAD SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> LODI , CA 95240 <br /> PHONE <br /> 209-941-2573 <br /> CONTACT PERSON <br /> LEN PULLIAM MAY 2 2 1995 <br /> SIG OF AUTHOMENT'I'TITLE DATE13 9d— ENVIRONMENTAL HEALTH <br /> • WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> g CONSTRUCTION SOIL ❑ ASH <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> ADWESSRICH HAMILTON TRUCKING 93d <br /> . CITY,STATE3Zlp PAULINE AVE . LOAD #4 <br /> 140DESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER;`;;, <br /> 209-57g-4100 X®( ❑ ❑ <br /> SIGNA URE <br /> OFA R1 ED AG NT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN <DRUMS <br /> �c , - /�21�75 Gt� � 13 -9� ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other / <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLET�D.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 IS101 OTHER'} <br /> waste for any reason. If Forward's refusal to accept the waste is based on �O <br /> weather or other site conditions, Forward shall notify the Disposer when "---- <br /> site— <br /> conditions are expected to change such that Forward will be able to accept-"- " <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> FACIbTY TICKFy.'f NIJAABER ASBESTOS <br /> i ///- ❑ WOOD <br /> NAT R �UT RIZ D ENT DATE <br /> _._ <br /> El ASH <br /> /� �� ❑ 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 THE DAY BEFORE. <br /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # Ci 5468 <br /> r;pNFRATOR(`f1AV <br />