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i <br /> R� • NON-HA�'DOUS WASTE MANIFEST <br /> Y, �� WASTE TR r, MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. SHR 0749 <br /> l <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> SAN FRANCISCO FRENCH BREAD ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS. ❑TY-VEK ❑OTHER <br /> 7801 EDGE'WATER DR. SPECIAL HANDLING PROCEDURES: <br /> CITY, STATE,ZIP <br /> OAKLAND, CA 94621 <br /> PHONE <br /> �510� 568-5511 <br /> CONT CT P RSON <br /> TOM. SOLONOIA <br /> SIG OF OF AUTHORIZEQ AGENT?TITLE DATE <br /> WASTE TYPE <br /> RECEIVING FACILITY <br /> i ' <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1444 S . LINCOLN ST. (209) 982- 1009 FAX <br /> STOCKTON , CA 95206 _ <br /> NAME NOTES: TRUCK NUMBER <br /> RICH HAMILTON TRUCKING v <br /> ADDRESS <br /> 1336 PAULINE AVE. <br /> CITY,STATE,ZIP <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP `TRANSFER <br /> - <br /> {209) 578-4101D El 11 <br /> NATURE OF AUT14ORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN ,- DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuslcynRDs <br /> _ Forward shall have no obligation to accept the waste if weather or other I-) <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL MI=THO (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the - <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 /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> _ E] WOOD <br /> SIGNATU ,E OF UTHORIZED AGENT„ ;, DATE. <br /> / ❑ 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 # 14753 <br /> TRANRPORTFR COPV <br />