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,�AWA11 /; NON-HA7V--)OUS WASTE MANIFEST <br /> C O R P O R A Fr-Dr WASTE Tt..^i MENT AND DISPOSAL FACILITY <br /> JOB AbQ&PTANCt NO — saaisi <br /> aENERATOR REQUIRED PERSONALPROTECTIVEEQUlPMENT <br /> GUNTERT STEEL ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 222 E. 4TH ST. <br /> CITY,STATE;ZIP r SPECIAL HANDLING PROCEDURES: ;� <br /> • RIPON, CA 95366 <br /> PHONE <br /> 29-599-6131 <br /> CONTACT PERSON <br /> CHRIS GUNTERT <br /> SIGNATUR F AUTHORIZED AGENT! TLE DATE <br /> * / /_ <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • Ej DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME NOTES: - <br /> TRUCK NUMBER <br /> RICH HAMILTON TRUCKING 9C 3 136 7 <br /> ADDRESS 9U <br /> 1336 PAULINE AVE. LOAD #4 <br /> • CITY,STATE, ZIP -1 <br /> MODESTO , CA 95358 SCS- X V FS aIS- <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 )n ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> * V 1 6. 97 ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS / <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 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 ❑ SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> • the waste. ❑ SLUDGE <br /> REMARKS <br /> • - -- ❑ NON-FRIABLE ._.. <br /> ASBESTOS <br /> FACILITY TICNUMBER <br /> / ❑ WOOD <br /> SIGNATURI�OF AUTHORIZED A6�7 DATE <br /> ASH <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIpR TO 4:00 P.M. THE DAY PRIOR TO EXPECYED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVkL.ON90ING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL (209) 982-429 <br /> - MANIFEST # 67479 <br /> TRANSPORTER COPY <br />