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NWARD <br /> 0 NON-H DOUS WASTE MANIFEST <br /> MWASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. <br /> 5k f <br /> 7NERATOR _ _ _' _� -- �- -- _- _ _ REQUIRED PERSONAL PROTEG"JiVEEQUIPMENT <br /> THRIFTY_` OIL Ct3P1PANY ❑GLOVES ❑GOGGLES QRESPIRATOR El HARD HAT <br /> MAILMG ADDRESS~ ' �� -x" ❑TY-VEK [:]OTHER <br /> 100000 LAKEW00© BLVD. — <br /> CITY,STATE, ZiP SPECIAL HANDLING PROCEDURES <br /> DOWNEY , CA- 90-240- . <br /> - PHONE <br /> 310-923-9876_ _-- <br /> CONTACT PERSON <br /> — DETERAAUTHORIZED <br /> _D ' AI+�ICO__ _ <br /> SIGNATURE AGENT/ TITLE DATE <br /> WAST€TYPE _ _ RECEIVING FACILITY <br /> d <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 /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY OIL 209) 982- 1009 FAX <br /> 1250 N . WILSON WAY <br /> STOCKTON, CA <br /> NAME t r ' NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING J <br /> ADDRESS <br /> 1338 PAULINE AVE. — LOAD 15 <br /> CITY,STATE, ZIP <br /> AGOESTO , CA 9535$ <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 Q ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AG�IVT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> j i r /F ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS _ <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 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 STOCKPILE OTHER <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 to accept <br /> the waste [:] SLUDGE <br /> REMARKS " - - <br /> - - -_ - - -- - - - <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NASBESTOSµ - W <br /> - - - — -_ w _ _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT - - - DAT_E_ T a - - <br /> * !� _ ! _ _ _ ❑ ASH <br /> PA <br /> . E❑ OTHER <br /> I <br /> SC LINT UST 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 <br /> MANIFEST # 27645 <br /> TRANSPORTER COPY <br />