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�' WARD • NON-HA4&DOUS WASTE MANIFEST <br />WASTE TR MENT AND DISPOSAL FACILITY <br />f - <br />JOB ACCEPTANCE NO. <br />'493 615 <br />GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />E Z. SERVE OF. CALIF. ❑GLOVES []GOGGLES []RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS' ❑TY-VEK ❑OTHER <br />P.D. SOX.922021 <br />CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES: <br />HOUSTON, TEXAS 77292-2021 <br />PHONE _-- <br />7 684-4312 <br />CONT RSON <br />lR�JIM SHIPLEY <br />SIGN TYRE OF AUTHORIZED AGENT/ TITLE I DATE <br />0 <br />TYPE <br />TREATMENT SOIL <br />❑ DISPOSAL SOIL <br />❑ CONSTRUCTION SOIL <br />GENERATING FACILITY <br />239 S. STOOCKTON ST. <br />RIPON, CA <br />❑ SLUDGE <br />❑ NON -FRIABLE ASBESTOS <br />❑ WOOD <br />❑ ASH <br />❑ OTHER <br />NAME <br />RICH HAMILTON TRUCKING . <br />ADDRESS <br />1336 PAULINE AVE. <br />CITY, STA73;0P <br />NOOESTO,CA 95353 <br />PHONE <br />(2O3) 57^0-4100 <br />SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE <br />FORWARD INC. LANDFILL <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 <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 <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, <br />conditions are expected to change such that Forward will be able to, accept <br />the waste. <br />REMARKS <br />FACILITY TICKET NUMBER" <br />SIGNATURE OF A" THORIZED AGENT DATE <br />`�Q �, Q� Gam- I ►Yn (c.l_�r <br />RECEIVING FACILITY <br />FORWARD INC. LANDFILL <br />9999 SOUTH AUSTIN ROAD <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />(209) 982-1009 FAX <br />NOTES: <br />LOAD #10 <br />TRUCK NUMBER <br />9CS0 <br />ENpDUMP BOTTOM DUMP TRANSFER <br />�•"Y ..- -.� ❑ ❑ <br />ROLL-OFF(S) FLAT-BED VAN - DRUMS <br />❑ ❑ ❑ ❑ <br />CUBIC YARDS <br />DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <br />DISPOSE BIO AERATE STOCKPILE OTHER <br />OIL _ <br />❑ SLUDGE <br />❑ NON -FRIABLE <br />ASBESTOS <br />❑ WOOD <br />❑ 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 />oUw!Z .v ncrwAi� vFON AnniVAL ONGOING uAiLT utuvtHIFS MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL(209)982-4298 14739 <br />MANIFEST # <br />