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NON-HAZ(—70US WASTE MANIFEST <br /> WARD -WASTE TREAT MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. CIM `, 8'a � <br /> GENERATOR REQF IRED I?ERSONAL PRQTECTNE EQUIPMENT-.1, <br /> THRIFTY OIL_COMPANY ❑GLOVES ❑GOGGLES [:]RESPIRATOR ❑HARD HAT <br /> -MAILING ADDRESS - �� ` ;- �� °, �� ❑TY VEK ❑OTHER <br /> 100000 LAKEWOOD BLVD. <br /> CRY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> DOWNEY,_-CA 90240 -�_-�----, <br /> - PHONE � 4 <br /> 310-88 923-9$76 <br /> CO_ NTACT PERSON -- — <br /> SIGNATURE O�FJIAUTHORIZED AGENT f TITLE_ _ DATE- <br /> WASTE TYPE_" _ -- 1 - RECEIVING FACILITY <br /> J <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • © DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD - <br /> E) CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY OIL (209) 982- 1009 FAX <br /> 1250 N. WISBON WAY <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> RICH HAMILTON__TRUCKINC <br /> ADDRESS <br /> 1336 PAULINE AVE. LOAD # 28 <br /> • CITY,STATE, ZIP <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578'Z44-00 _ E7 El 1:1SIGN%ATLI U ORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BEb VAN DRUMS <br /> *r'/ ❑ ❑ ❑ ❑ <br /> FORWAD INC. LANDFILL CUBIC YARDS _V <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 �018POSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability, to accept the __ __ _ STOCKPILE - <br /> OTHER <br /> for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site <br /> conditions are expected to change such that Forward wrli be able to accep <br /> • the waste — ❑ SLUDGE <br /> REMARKS _ `y <br /> " - - NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET-NUMBER - <br /> _ w _ ❑ WOOD <br /> SIG TORE AU#1 <br /> _5 E AGENT DATE <br /> ❑ ASH <br /> *I, — t/ __/t--� fir'- �� �� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 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 WISH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4296 MANIFEST # 27658 <br /> 8 <br /> TRANSPORTER COPY <br />