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NO0N-HAZOUS WASTE MANIFEST <br /> RD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. `, JOB ACCEPTANCE N0. <br /> GENERATOR . - _ - -, - - �REQUIRED PERSON PROTECTIVE EQEIIPMENT <br /> _ THRIFTY OIL COMPANY _ []GLOVES OGOGGLES RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS _~_ _`ry_ s` s ❑TY-VEK [:]OTHER <br /> _ 100000 LAKEWOOD BLVD. <br /> CITY,STATt=,ZIPZIP SPECIAL HANDLING PROCEDURES <br /> • DOWNEY, CA 90240 <br /> PHONE <br /> 310-923-9876 <br /> CONTACT PERSON__- PETER ' AMIETO__ <br /> SIGNum- <br /> ORIZED AGENT/ TITLE DATE— ^ <br /> * - - - - - <br /> WAS)RYPE___ __ ___ _ RECEIVING FACILITY 4* _ <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL [❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ® DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <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 s "�TRUtKNUMBER <br /> ADDRESS H HAMILTON TRUCKING <br /> 1.336 PAULINE AVE. LOAD #16 <br /> • CITY,STATE, Z1P <br /> MODESTO, CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 ❑ ❑ ❑ <br /> SIGNATURE OF AU ORIZED GENT OR DRIVER DATE ROLL-OFFS) FLAT-BED - VAN DRUMS <br /> 11-o -<I/ <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other f q <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 810 AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site SOIL <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 'T'v' <br /> _ _ _ _ � <br /> SIGNATURE OF AURI <br /> THOZED AGENT k - DATE ❑ WOOD <br /> - - <br /> f ❑ ASH <br /> * l /1 `� ` El OTHER <br /> SCE U MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS ARE <br /> SU CT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DRAY BEFORE <br /> r <br /> TO SCHEDULE CALL(209) 982-4298 MANIFEST # L 7 6 4 V <br /> TRANSPORTER COPY <br />