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NOWWtA ) DOUS WASTE MANIFEST <br /> wA jqWASTE7REATMENT AND DISPOSAL FACILITY <br /> 0 <br /> �- JOB ACCEPTANCE N0. <br /> GENERATOR -REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 1T - <br /> E.Z..-SERVEOF CALIF ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS Fl ,'w= .; n r'f " ,� ❑TY-VEK []OTHER <br /> - <br /> .P D BDX. 9Z2O21,,._,.,.,,,,,� SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE ZIP'W5 u.. : �._.. <br /> HOUSTON,-.TEXAS-77292-2021 <br /> PHONE <br /> 7 684-4312 <br /> CONfA .P RSON x <br /> R JIM. SHIFLEL. <br /> SIG E; F AUTHORIZED AGENT l <br /> I WAS TYPE RECEIVING FACILITY <br /> -- - _,. �... . .,r. . _. .. -_ <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 /> i GENERATINGF6CILITY (209) 982-4298 PHONE <br /> 239 S. STOCKTON ST. (209) 982- 1009 FAX <br /> RIPON, CA <br /> ii <br /> `NOTES " TRUCK NUMBER <br />* NAME., .. >._ ,.. . ., .. ,. . �,._ .,.-,a . .>. , . . . _ . ... <br /> j <br /> iC H HAMILTON.-.,TRUCKING <br /> ADDR�SS <br /> 3�6 PAULINE AVE LOAD #3 <br /> • CITY, TATE ._ <br /> MODESTO.,CA 95358. <br /> PHONE ' END DUMP BOTTOM DUMP f.. TRANSFER <br /> El <br /> 200) 578-4100 . . -- BED <br /> El El . <br /> NA URE OF AUTHORIZED AGENT.OR,DRIVER `!, DATE ': ' -ROLLOFF(S) . FLAT- <br /> El <br /> ❑ ❑N '•:_DRU❑MS" <br /> FORWARD INC. LANDFILL cuelc vARDs. <br /> Forward shall have no obligation to accept the waste if weather or other '` 15 C.Y. <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 `; DISPOSE BIO', AERATE E STOG_c?IiE - OTHER - <br /> I waste for any reason. If Forward's refusal to accept the waste is based on SOI <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 t_., <br /> NON-FRIABLE <br /> _ ❑ ASBESTOS <br /> f - ~� ❑ WOOD <br /> SIGNA� RE'OFAUTHORIZEDAGENT "'< ire � -' DATE <br /> r <br /> ❑ ASH <br /> t * � �-- - ❑ OTHER <br /> !� SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> J SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> I TO SCHEDULE CALL(209)982-4298 <br /> MANIFEST # 14732 <br />