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,at WARD NON-HA7-5�7710US WASTE MANIFEST <br /> WASTE T„tel HENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. saalii <br /> GENERATORi REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GUNTERT STEEL ~� El GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS r ,• ` ❑TY-VEK [-]OTHER <br /> 222 E. 4TH ST. <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES:- <br /> ; RIPON , CA 95366 <br /> PHONE <br /> 209-599-6131 <br /> CONTACT PERSON <br /> CHRIS GUNTERT <br /> SIGNATU51f OF AUTHORIZED AGENT DATE <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 /> El OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209)982- 1009 FAX <br /> NAME NOT r-.. TRUCK NUMBER <br /> RICH HAMILTON TRUCKING 9 %J 91/l <br /> ADDRESS / g� (� <br /> 1336 PAULINE AVE. LOAD #2 <br /> . CITY, STATE, ZIP <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 ® ❑ ❑ <br /> (SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE - ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> J FOROMRD INC..LANDFILL CyBICYARDS �> <br /> Forward shall have no obligation to accept the waste if weather or other <br /> - i <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TOB COMPLETED BY FORWARD) <br /> impairs the safe and,effective operation of the Landfill. Forward shal"se_ - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the - O BIO' AERATE�STCCKPILE 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 potify the Disposer when sites <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. UDGE <br /> ` REMARKS- - <br /> ”- ❑ NON-FRIABLE . <br /> FACILITYTI KET NUMBE �, ASBESTOS.., ❑ WOOD <br /> SIGNATU E OF AUTHORIZ AGENT ' DATE <br /> ASH <br /> OTHER <br /> SCHEDULING MUST BE MADE PIIII TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARR G DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # 49624 <br /> TRANSPORTER COPY <br />