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_NON-I DOUS WASTE MANIFEST <br /> WARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> �lfvr. - 4 - <br /> a + <br /> JL�B•ACCEPTAN'CE N0. cNN F 1288 <br /> GENERATOR------- = , RE UIq ED PERSONAL PRQTECTNE EQUIPMENT <br /> THRIFTY DIL COMP N �-- } ❑GLOVES LI—GOGGLES []RESPIRATOR [—]HARD HAT <br /> MAILING ADDRESS k — '-�� ❑TY VEK []OTHER <br /> 100000_LAKEWOOD--BL,110- _ -.---_-�---_.�-.- <br /> YSTATE, ZIP SPECIAL HANDLING PROCEDURES <br /> • CIT , � <br /> DOW LEY, _CA- 90240 �--- <br /> PHONE <br /> 310-923>-9[ 75 <br /> CONTACT PERSON _ _ _ <br /> PETtR D'AIS - ' <br /> SIGNAT_UR OF AUTH ZED AGENT/TITLE DATE <br /> WASTE TPE _ RECEIVIN_G FACILITY_ <br /> x ❑ 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 /> GENERATING FACIUTY (209) 982-4.298 PPONE <br /> THRIFTY OIL 209) 982- 1009 FAX <br /> 1250 N . WILSON WAY ( <br /> STOCKTON , CA ` <br /> NAME NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESS t� <br /> 1336 PAULINE AVE . LOAD # 33 <br /> • CITY,STATE, ZIP <br /> 110DESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 0 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste of weather or other {ff <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 - DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _ - _ _ - <br /> waste for any reason If Forwards 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 - T - - - _ -- <br /> - - NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> rr�� __ _ _ _ — - - ❑ WOOD <br /> SIGN OF U�ORIZL AGENT DATES <br /> - ❑ 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 # 2 7 6 6 3 <br /> TRANSPORTER COPY <br />