Laserfiche WebLink
NON-HA 'DOUS WASTE MANIFEST <br /> R WARD • WASTE TRRWMENT AND DISPOSAL FACILITY <br /> .III .✓ <br /> \[NC. JOB ACCEPTANCE NO, <br /> GENERATOR REQUIRED_PERSONAL PROTECTIVE EQUIPMENT s <br /> SAN FRANCISCO FRENCH BREAD ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS [:]TY-VEK ❑OTHER <br /> 7801 EDGEWATER DR . SPECIAL HANDLINGPROCEDURES: <br /> CITY,STATE,ZIP <br /> • OAKLAND , CA 94621 <br /> PHONE - <br /> (510) 568-5511 <br /> CONTACT PERSON <br /> TOM SOLDONIA <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE n, / <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> F-1TREATMENTSOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • E2 DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY (209) 982-4298 PHONE <br /> i <br /> 1444 S . LINCOLN ST . (209) 982- 1009 FAX <br /> STOCKTON , CA 95206 <br /> NAME NOTES: TRUCK NUMBER <br /> RICH HAMILTDN TRUCKING O <br /> ADDRESS <br /> 1336 PAULINE AVE , <br /> • CITY,STATE,ZIP <br /> MODESTO , CA 95358 <br /> • PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (209) 578-4100 © ❑ ❑ <br /> SIGNATURE F AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) ; FLAT-BED VAN DRUMS <br /> ( �, ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cualc YARDS <br /> Forward shall have no obligation to accept the waste if weather or other <br /> VQ <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 useDISPOSE 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 L <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-FR ABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER ❑ WOOD <br /> SIGNATU F AUTHORIZED AGENT DATE <br /> /: l �� ASH <br /> V j 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 # 14755 <br /> TRANSPORTER COPY <br />