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' NON-HAS-'DOUS WASTE MANIFEST
<br /> :. FWARITj °• WASTE I_,ENI MENT AND DISPOSAL FACILITY
<br /> Mgp° r- JOB ACCEPTANCE N0. ;s3sa5f
<br /> GENERATOR REQUIRED PERSONAL,PROTECTIVEEQUIPM_E_N__T )
<br /> ...__
<br /> E�7� SERVE.pOF CALIF � ,. v ❑GLOVES ❑GOGGLES ❑RESPIRATOR E]HARD HAT
<br /> MAILIt AMRESS „ "„- ,,;,,,., rm,,, ❑TY-VEK El OTHER
<br /> TA7P o� ZIP gpX-922021 , - �- ,------, :r SPECIAL HANDLING PROCEDURES:
<br /> C_ITY S
<br /> • HOUSTON,, TEXAS 77292 2021 ,,, _
<br /> 1 4312.. .,7 r
<br /> CONT F{§4 7' '..; ' ..,i.t,.._.�,
<br /> SIG. MR E OF AUTHORIZEDAGEDATE }'
<br /> • WASTETYPE RECEIVING FACILITY_..
<br /> - I
<br /> ❑ SLUDGE
<br /> v TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL
<br /> I ❑ DISPOSAL SOIL ❑ WOOD. 9999 SOUTH AUSTIN ROAD
<br /> .. ❑ CONSTRUCTION SOIL - ❑ ,ASH
<br /> ❑ OTHER MANTECA, CALIFORNIA 95336
<br /> • GEr1ERAnNGFAcIUTv (209) 982-4298 PHONE
<br /> 239 S. STOCKTON ST.
<br /> RIPON4 CA (209) 982- 1009 FAX
<br /> 1
<br /> NAME:-, NOTES ::'.::TRUCK NUMBER.
<br /> f
<br /> RICH .HAMILTON- TRUCKING ,i
<br /> ADDRESS,
<br /> 1336 PAULINE�. AVE. LAOD #7 CITY,STATE ZIP._; . .'.� -
<br /> MODESTO,CA 95358
<br /> i PHONE ;TRANSFER.
<br /> j209) 578-4100 , 4 ❑ El
<br /> SIGN ATTURE OF AUTHORIZED AGENT CR DRIVER' DATE ROLL-OFF(S) FLAT-BED {_VAN -DRUMS_
<br /> ❑ ❑ ❑ ❑
<br /> tmd LL,
<br /> FORWARD INC. LANDFILL cuBlc vARos
<br /> 1Forward shall have no obligation to accept the waste if weather or other 15 C YDS
<br /> DISPOSAL conditions impair the safe and effective disposal of the waste or if the waste L 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 STOCKPILE ':OTHER
<br /> waste for any reason. If Forward's refusal to accept the waste is based on SOIL
<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 ' - :
<br /> cs'ib,-..,., fa�''ri .x.a ..<. ,::,Td.,:�........n :;..,,_ ❑ NON-FRIABLE .
<br /> -'x'Tu s ��: ASBESTOS
<br /> FACILITYTi CKETNUMBER; ; ;„�,,, x� „
<br /> {I ❑ WOOD
<br /> 4
<br /> l SIGNATURE OF AU ORIZED !a, >=>,a;:` DATE
<br /> El 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 :N MANIFEST # 14736
<br /> j, TO.MCD(IOTCD!`/lOV
<br />
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