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RWARD NON-HAWDOUS WASTE MANIFEST <br />WASTE TFWMENT <br />AND DISPOSAL FACILITY <br />JOB ACCEPTANCE N0. s 61s <br />GENERATOR _ <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />OF CALIF,- <br />[]GLOVES❑GOGGLES❑RESPIRATOR ❑HARD-HAT <br />MAILINZiADDE <br />R!`SS <br />.n922021 <br />❑TY-VEK ❑OTHER <br />pp nn <br />CITY, SI�T�F922021 -: rr <br />SPECIAL HANDLING PROCEDURES: <br />• PHONEOUSTON,ggTEXAS 77292-2021 _ <br />• - -" -- <br />CONT P�RSON4-433172' <br />T OF AUTHORIZED ,DATE <br />SIG RE AGENT / TITLE _ - <br />WASTE TYPE <br />RECEIVING FACILITY <br />❑ SLUDGE <br />LI TREATMENT SOIL <br />❑ NON FRIABLE ASBESTOS <br />FORWARD INC. °LANDFILL - <br />❑ DISPOSAL SOIL <br />❑ WOOD <br />❑ CONSTRUCTION SOIL <br />❑ ASH - <br />9999 SOUTH AUSTIN ROAD <br />• <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATINGFACILITY <br />233 STOCKT0;1 Sr. <br />RIPON, CA <br />(20/9) 982-1009 FAX <br />NAME <br />NOTES: TRUCK NUMBER <br />RICH HAMILTON TRUCKING <br />ADDRESS <br />1335 PAULINE AVE. <br />✓ <br />LOAD # 11 <br />- CITY, STATE, ZIP <br />MODESTO,CA 95358 <br />END DUMP BOTTOM DUMP TRANSFER <br />PHONE <br />(209)/578-4100 <br />Cq ❑ ❑ <br />SIGNATU ,OF AUTHORIZED-AGENT OR DRIVER DATE <br />ROLL-OFFS) FLAT-BED VAN DRUMS <br />El 11 El <br />FORWARD INC. LANDFILL <br />CUBIC YARDS <br />Forward shall have no obligation to accept the waste if weather or other <br />15 C. YDS. <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 />DISPOSAL METHOD: - (TO BE COMPLETED BY FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />- DISPOSE BIO AERATE STOCKPILE 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 <br />I <br />when site <br />conditions are expected to change such that Forward will be able to accept <br />the waste. <br />- <br />REMARKS ...... - .... .., ' : - z..._ <br />❑SLUDGE <br />❑NON-FRIABLE <br />,..,. .._ , a._ .,,,...,,., <br />FACILITY TICKET NUMBER . :. :....a. <br />ASBESTOS <br />❑ WOOD <br />- <br />-,:-:..: ..ms's <br />SIGNATURE\ A ORIZE AGENT DATE . ...: <br />}\,1 <br />❑ ASH <br />?�1 a <br />% <br />OTHER <br />SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO <br />EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST <br />BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL (209) 982-4298 <br />MANIFEST # 14740 <br />