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r ; ,wAR�� r' NON-H/"ARDOUS WASTE MANIFEST <br /> INC. WASTE MtATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. — 756411 <br /> GENERATOR <br /> California Welding Supply UIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MPLOVES [-]GOGGLES ❑RESPIRATORHARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> P000 E. 11th 'St. <br /> CITY,STATE,ZIP _ SPECIAL HANDLING PROCEDURES: <br /> Tracy, CA <br /> PHONE none <br /> (209)466-8604 <br /> CONTACT PERSON <br /> Wm. J Hu er <br /> SIG R UTHORIZ AGE /TITL DAA <br /> WASTE YPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [3 DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> Same as above (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> Jim thorpe Oil , Inc. <br /> ADDRESS ! r r L/ 3 2- <br /> v <br /> P.O. box 357 VLA, �� <br /> • . CITY,STATE,ZIP ) <br /> • Lodi, CA 95241-0357 ` <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> • (209)368-6175 Ek ❑ ❑ <br /> SIGNATURE OF AUTHORIZED'At-ENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> e7F El <br /> FORWARD INC. LANDFILL CUBIC YARD <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 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 DIS OSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on IL <br /> weather or other site conditions, Forward shall notify the Disposer when sit cs <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 /> ❑ WOOD <br /> SIGNATURE O ED A E T DATE <br /> � G� ❑ 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 # 20870 <br /> C�E'.,ER.A 0R COPY <br />