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_ e � —Y " T NON;HAZC)OUS WASTE MANIFEST <br /> RD. - r <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> FrW1 <br /> � rJORACCEPTANeaO.,� . HM <br /> Y <br /> :Si O <br /> GENERATOR r fiE9�_i3EF?_#' -RSQNAL PkI'iOTECTIV �QI�}P�IAENT � <br /> THRIFTY OIL COMPANY ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAfL_Ldq ADDRESS ,-.T" "-,�� =1 s �s w= r p ❑TY-VEK ❑OTHER <br /> 10606-0 BLft'. - - ., SPECIAL HANDLING PROCEDURES <br /> • CITY,STATE,ZfP ___ =���g �_ - <br /> K <br /> • PFioN�awNBY cA _VZ40 <br /> - <br /> 330-923-19876 <br /> CONTACT PERSON-- <br /> PETER VAMICO <br /> SIGNA URE OF UTHORIZED AGENT f TITLE — DATE_ <br /> • <br /> WASV TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ® DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> E] CONSTRUCTION SOIL ❑ ASH 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 - NOTES TRUCK NUMBER <br /> ADORRS�H HAMILTON TRUCKING- �- -- 960 <br /> • CrTY,S q.3� PAULINEAVE. - LOAD # 10 <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> lfl ` 209-573-4100 ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE r ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS r <br /> Forward shall have no obligation to accept the waste if weather or other r <br /> conditions impair the safe and effective disposal of the waste or if the waste DI POSAL 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 Forwards refusal to accept the waste is based on - <br /> weather or other site conditions, f=orward 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 /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> _ _ __r :k_ ❑ WOOD <br /> SIGN�TUR O AU O AGENT' <br /> - 7_ED- — -- j ❑ ASH <br /> * l'- <br /> AV [:] 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_7640 <br /> TRANSPORTER COPY <br />