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I ,;` �,(�' NON-HA,?(��OUS WASTE MANIFEST <br /> �� � WASTE ti�At MENT AND DISPOSAL FACILITY <br /> �• JOB ACCEPTANCE NO. <br /> EQUIRED.PERSONAL--PRO TECTIVEEQUIPMENTF <br /> E_Z SERVE OF CALIF it ❑GLOVES []GOGGLES❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ' ,• ❑TY VEK - ❑OTHER - <br /> .._P.0 80X.,922021 ...,,,.,. �.,- -.c SPECIAL HANDLING PROCEDURES: - <br /> CITY.,STATE,ZIP <br /> • ,HOUSTON, TEXAS77292 2021 <br />! PHONE;,., •.<t ;.��;.' ...:.. t .�.__ .:c�4 ..,..—i;_.♦:_. ..._...,�.�, <br /> CONT RSON <br /> R JIM..SHIFLET.... d <br /> SIGN T E OF AUTHORIZED,AGENT,/TITLE L DATE <br /> S * I G? <br /> WASTE TYPE ; RECEIVING FACILITY <br /> ❑ SLUDGE <br /> (a TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> f ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> w <br /> GENERATING FACIUTY (209) 982-4298 PHONE <br /> { 239 S. STOCKTON ST. (209) 982- 1009 FAX <br /> RIPON CA <br /> �. NAME - ', , NOTES _ �.... _. . _TRUCK NUMBER <br /> p,,ICH HAMILTON TRUCKING 9 C".3, � <br /> ADDR S <br /> { 1336 PAULINE AVE. ,,. LOAD #10 <br /> �. • CITY,STATZIP, <br /> h10D1=.STO,CA 95358;. r —ENO DU GIP BOTTOM TRANSFER <br /> PHONE 15 <br /> 578-4100 <br /> ..._ 15x +!iT --. <br /> (203 578-4100 <br /> SIGNATURE F AUTHORIZED AGENT OR DRIVER DATE ROLL OFFS) .; FLAT-BED❑ . VAN DRUMS <br /> FORWARD INC. LANDFILL cuelcvARDs .., <br /> I <br /> Forward shall have no obligation to accept the waste if weather or other 15 r. YOS <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 sale and effective operation of the Landfill. Forward shall use DISPOSE . ,.BIO AERATE SfUCKPILE ,;OTHER <br /> reasonable efforts to promptly notify Disposeri of its inability to accept the ;,': �L,... . . ... -_.: . IL .,,q <br /> waste for any reason. If Forward's refusal to accept the waste is based on OIL <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 toacdept - <br /> the waste. ❑ SLUDGE <br /> NON-FRIABLE <br /> :. .. +, -,._,. ❑ ASBESTOS <br /> I FACILITY TIC KET�NUMBER.._w, _,,. a ;fes 3:: ° r..; . ._.' <br /> - - - ❑ WOOD <br /> SIGNATi1 E.OF_X "THORN D AGENT yy <br /> li ❑ ASH <br /> i <br /> 10J. — 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# 14739 <br />