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NONAZARDOUS WASTE MANIFEST <br /> ■ WASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC_ JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 4ALER INDUSTRIES ❑GLOVES []GOGGLES []RESPIRATOR ❑HARD HAI <br /> MAILING ADDRESS ❑TY-VEK []OTHER <br /> 40 Ashler Ave. <br /> -CITY,STATE,ZIP - SPECIAL HANDLING PROCEDURES: <br /> Los, Gatos, CA 95030 NONE <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE - DATE. <br /> * Nt contracto 11/14/95 <br /> WASTE TYPE _ RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ElTREATMENT SOIL ElNON-FRIABLEASBESTOS 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 {RHONE <br /> 75 Alpine Ave. <br /> Stocaon, CA (209) 982- 1009 FAX <br /> NAME NOTES: 'TRUCK NUMBER <br /> JIM7,10P.PE OIL, INC. <br /> ADDRESS <br /> i <br /> P. 0. 3OX 357 <br /> . CITY;_STATE,ZIP ; j <br /> Lodi , CA 95241-0357 <br /> PHONE, - ) DUMP .BOTTOM.BOTTOM DUMP, .: .TRANSFER <br /> (209) 368-5175 Ej ❑ ❑ <br /> SIGNATURE OF AUTHORIZED'AGENT ORDRIVER DATE . ROLL-OFF(S) :FLAT-BED ' `VAN. DRUMS ' <br /> 11/14/95 ❑ ❑ — ❑ ❑ <br /> FORWARD INC. LANDFILL cusrcYARDs <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 DISPOSAL <br /> reasonable efforts to promptly notify Disposer of its inability to accept the 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 when site (- <br /> conditions are expected to change such that Forward will be able to accept i <br /> ` the waste. ❑ SLUDGE <br /> REMARKS <br /> . . _ ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER : - _ ASBESTOS <br /> ❑ WOOD r <br /> SIGNATURE OF AUTHORIES.�GENT DATE <br /> ❑ ASH <br /> y�* ,� -•.c. , . "G3^.f i ❑ 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 <br /> _�„�, __ ,• MANIFEST * 41 93 9 <br />