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r NON-HAZ OUS WASTE MANIFEST <br /> ARS A WASTE TRE rr NT AND DISPOSAL FAMITY <br /> C y <br />' 1N <br /> JOB ACCEPTANCE NO. <br /> GENERATOR -REQUIRED PERSONAL PRaTECTNE EQUIPMENT , <br /> THRIFTY- OIL COMPANY ❑GLOVES Q GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILNG ADDRESS y _- : w _ - , [:]TY-VEK - ❑OTHER <br /> 100000 LAKEWOOD LAKE4dOQE]_$Llf[ •-- - -- SPECIAL HANDLING PROCEDURES <br /> CITY,STATE„ZIP F M� - ___ 4( <br /> + DOWNEY,_ CA 90-240---- <br /> PHONE <br /> 0240 -_—PHONE <br /> 310-823-9876 <br /> CONTACT PERSON -- — -- — -"�- -- <br /> - - PETER AN I]' AMIC_0 <br /> i <br /> TURE OF UTHORIZED AGENT/TITLE DATE <br /> • <br /> Wt E TYPE _ __ - - - - RECEIVING FACILITY <br /> - --- <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 . IWILSOaN WAY <br /> STOCKOTN , CA <br /> NAME NOTES 1 — -'TRUCK NUMBER , <br /> ADDRES-SCH HAMILTOUCITRUCKING <br /> • CITY, ERAT ZI�AULINE <br /> AVE.- LQA�# 19 <br /> PHOd O D E S T 0 , CA 95358 END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-41CO ® ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRNER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC vaRDS <br /> Forward shall have no obligation to accept the waste if weather or other /S— <br /> conditions <br /> S- <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSA HOD (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 ❑� OIL <br /> weather or other site conditions, Forward shall nota hen the Disposer wsite <br /> ' conditions are expected to change such that Forward will be able to acce t_ <br /> the waste ❑ SLUDGE <br /> • REMARKS - - w - --�-� - - <br /> '" _ NON-FRIABLE <br /> _ _ _ __ _ __ ❑ ASBESTOS <br /> FACILITY TICKET NUMBER _-- <br /> - <br /> E] WOOD <br /> SIGNATURE O CJTHQRIZED / EN'f 3 DATE _ <br /> /7OASH <br /> ro OTHER <br /> SCHEDULING MUST BE MADE PRIOR to_466 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 4 9 <br /> TRANSPORTER COPY <br />