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ACMi`�`- ` NON-HA US WASTE MANIFEST <br /> WARD _ WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO, u 14 = s ` <br /> GENEREtTOFx-- REQUIRED PERSONAL PROTECTIVE EQ PMENT r <br /> _ THRTF7Y q L CQ_M_E ANY ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> 11iC�C1>'IRG ADDRESS 7 ❑TY-VEK []OTHER <br /> i0000a LAK_Uw�s%n o: � � � _ <br /> C_IT_Y,STATE,ZIP _ ^� Y 3, SPECIAL HANDLING PROCEDURES <br /> • DOWNEY_&-CA 90240 <br /> PHONE <br /> 31Q-923-3876 <br /> CONTACT PERSON - <br /> PETER D' AMICO -__ - <br /> SIGNA�TUURE OF All HO jR_IZED_AGENT/TITLE <br /> • WASTE TYPE _ RECEIVING FACILITY �- <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 <br /> 1250 N . WILSON WAY (209) 982- 1009 FAX <br /> STOCKTON , CA <br /> NAME _ -NOTES V TRUCK NUMBER <br /> f RICH HAMILTON TRUCKING ' <br /> ADDRESS 9 sD <br /> 1336 PAULINE AVE. - - LOAD #4 <br /> • CITY,STATE,ZIP <br /> MODESTO , CA 95358- <br /> PHONE _ END DUMP BOTTOM DUMP TRANSFER <br /> RXIix 209-578-4100 ;® ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE_ ROLL-OFFS) FLAT-BED VAN DRUMS <br /> El El El <br /> FORWARD INC. LANDFILL D <br /> Forward shall have no obligation to accept the waste if weather or other cuBlc Y <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 BIO 1 AERATE SMCKPILE OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site Q 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 - - <br /> - -- - _ ❑ WOOD <br /> Slb ATURE OF AUl`HORRZED AGENT _ - DATE <br /> - El ASH <br /> 1 i / <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 /> '1140-SCHEDULE CALL(209)982-4298 MANIFEST # 2 7 6 3 4 f <br /> TRANSPORTER COPY <br />