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r - <br /> FAnWdftj!WAR - NON-H OUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> M JOB ACCEPTANCE NO. CNN 1288 <br /> GENERATOR _ 4 ' SR REQUIRED PERSONAL PROTECTIVE EQUIPMENT_. <br /> TH.RIFFY_0ZL _MKP M _ QGEOVES []GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESS _ ❑TY VEK []OTHER <br /> _10D000__LAKEk. O0_BLV_n <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> DOWNEY PA_ 90290-_ <br /> - PHONE — - <br /> 3 <br /> CONTACT PERSON <br /> PETERL�'AMICO_SIGNA URE OFORIZED AGENT-/TITLE DATE <br /> • WASTP!TYPE RECEIVING FACILITY <br /> °r ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [y� 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 , <br /> 1254 N . WILSON WAY (209) 982- 1009 FAX <br /> STOCKTON , CA <br /> NAME- _ ' NOTES _ t TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESS ct 3 U <br /> 1336 PAULINE AVE . LOAF} #12 <br /> • CITY,STATE, ZIP <br /> MODESTO CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 ® ❑ ❑ <br /> SIGNATURE OF AU IZED A ENT OR DRIVER DAVE 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 2 S <br /> conditions impair the safe and effective disposal of the waste or if the waste D[SPOSAL 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 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 Forward shall notify the Disposer when si ❑ 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 /> .--- ---� �—J- -.------ -- <br /> FACILITY TICKET NUMBER- <br /> ASBESTOS <br /> - _ - - - __ - - _-- — --- -- ----- -- - -- [:1 WOOD <br /> SIGN 9E, OF UTHORIZED RGEN� --- - - - DATE` - - <br /> ! 4 • - - P - — —-- ❑ ASH <br /> �`� �� ❑ 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# 2764 2 <br /> " TRANSPORTER COPY <br />