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WARD NON-HA DOUS �IVASTE MANIFEST <br /> WASTE TR�TMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. <br /> CMM — 4074 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVEEQUIPLiENFR ,e:" .-,II <br /> KOA KAMPGROUNDS []GLOVES ❑GOGGLES ❑RESPIRATOR I-]HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 2851 E . EIGHT MILE ROAD SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP - <br /> • LODI , CA 95240 <br /> PHONE <br /> 209-941-2573 <br /> CONTACT PERSON <br /> GLF�O PULLIAM <br /> SIGNA RIZ NT/1JT <br /> AUTHOLE DATE <br /> �k <br /> • WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • p DISPOSAL SOIL ❑ WOOD gggg SOUTH AUSTIN RCjAD <br /> ❑ CONSTRUCTION SOIL r-1ASHRdAD <br /> OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY (209) 982-4298 PHONE <br /> K L n (209) 982- 1009 FAX <br /> NAME NOTES: y h fRUCX(( BEq: <br /> ADDRESSCH HAMILTON TRUCKING 6 V <br /> , <br /> • CITY,4AIJVAULINE AVE. LOAD #3 <br /> • PHONE�ODESTO , CA 95358 <br /> END DUMP BOTTOM DUMP '.'TRANSFER <br /> 2pDDgg. 78-4100 ❑ ❑ <br /> SIGNATURE O AUTHORIZED AGENT OR DRIVER DATE ROLL—OFF(S) FLAT-BED VAN DRUMS ' <br /> El El El 11 <br /> — 3- 95 <br /> FORWARD INC. LANDFILL CUBIC YAR jD/ys�/ �' <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 ME D: (TO BE COMPLETED 13Y FQRWARQ <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 ,PTW* <br /> waste for any reason. If Forward's refusal to accept the waste is based <br /> weather or other site conditions, Forward shall notify the Disposer when siton 0 SOIL <br /> • conditions are expected to change such that Forward will be able to accept . <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> -1 _. �- ❑ WOOD <br /> SIGNAPAE OAUTHORI D/GENT ) DATE <br /> ❑ ASH <br /> *�__�._ �� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR O 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 <br /> rcntFaaTrlCt'r`nw MANIFEST # Ci 5467 <br />