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NOWHAZOUS WASTE MANIFEST <br /> ARn <br /> ' {WASTE TR ENT AND DISPOSAL FACILITY f <br /> INC.. JOB ACCEPTANCE NO. ,cq_�', zss <br /> GENERATOR -_ �_ ___ __ - REQUIRED PERSONPROTECTIVE EQUIPMENT <br /> AL❑GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS <br /> ❑TY-VEK ❑OTHER <br /> 100000LAKEW0QD BLVQ ._ SPECIAL HANDLING PROCEDURES <br /> CITY_STATE,ZIP_ <br /> - <br /> + <br /> PHONEOOWNEY*,`CA 90240 <br /> 310-923-9876 <br /> CONTACT PERSON--- - - —- _- -- - `- <br /> PETER w AMIGO <br /> SIGNATURE OF AU_THOZZ'F/ <br /> D AGENT/TITLE DA - <br /> V 146 <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 . WILSOJ WAY (209) 982- 1009 FAX <br /> STOCKTON , CA <br /> NAME 5 NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESS cl-,30 <br /> 1336 PAUL,INE AVE. LOAD #a <br /> CITY,STATE, ZIP - <br /> • MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 203-578-4100 F3 ❑ ❑ <br /> SIGNATURE OF AU RIZED A ENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC Y DS <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 DISPOSE BIO AERATE 5TOCKPLE _ OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on LIS <br /> OIL <br /> or other site conditions, Forward shall notify the Disposer when site J ff--ISOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> ` the waste _ ❑ SLUDGE <br /> REMARKS - __ � - <br /> _ ❑ NON-FRIABLE <br /> - - -- <br /> FACILITY TICKET NUMBER ASBESTOS <br /> E] WOOD <br /> SIGNATURE_OF A_UTHORIZED AGENT DATE - - <br /> __ _ _ - - ❑ ASH <br /> f � c5 o ❑ OTHER <br /> SCkeDULINWMUST 13E 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 # 2 7 6 3 5 <br /> TRANSPORTER COPY <br />