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0 _ <br /> NON-H OUS WASTE MANIFEST <br /> a Fps WASTE TRENT AND DISPOSAL FACILITY <br /> IN �M w <br /> JOB ACCEPTANCE NO. TORR 4 12 7 <br /> GENERATOR_ REQUIRED PERSONAL PROTECTIVE EQIAF1W_L T. ^ � <br /> THRIFTY_0IL-COMP_W-, ❑GLOVES ❑GOGGLES El RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS _ t' �' ='�-�'r ❑TY-VEK ❑OTH�R <br /> 100000-LAKEWOOD-111-VD.— SPECIAL HANDLING^PROCEDURES <br /> CITY,STATE,ZIP <br /> • DOWNEY.-CA 9024(].__-- <br /> PHONE - <br /> 310-923-9876 <br /> CONTACT PERSON <br /> pErlrR AXX D ' AMzca - <br /> SIGN/ URE O AUTHORIZED AGENT / TTfLE_ DATE <br /> WASTE TYPE RECEIVINGfACILITY <br /> ❑ <br /> SLUDGE ' <br /> ❑ TREATMENT SOIL ❑ SLUDGENON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> F-1CONSTRUCTIONSOIL ❑ ASH ASH Y ,� <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY OIL <br /> 1250 r) . 14ILs0r1 WAY (209) 982- 1009 FAX <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING � � V�` <br /> ADDRESS <br /> 1336 PAULINE AVE . LOAD #13 <br /> CITY, STATE, ZIP ' . <br /> tODESTO , CA MX29X 35358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 ® ❑ ❑ - <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 4DISPOSE 13_10 AERATE STOCKPI OTHER <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 <br /> ' T ❑ NON-FRIABLE <br /> FACILIT)f-7C�ET MBR 4 _ _ _T Y - ASBESTOS <br /> E] WOOD <br /> SI T O AU RIZ A I1T_ _ f� E -- _ <br /> 7 G� ❑ ASH <br /> � ( r/ ❑ OTHER "low <br /> SCHEDULING MUST BE MADE P I 4"00 P M THE DAY P IOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARR VAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4298 <br /> `�— MANIFEST# 2 7 6 4 3 <br /> TRANSPORTER COPY `�I <br />