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NON-HA. r?DOUS WASTE MANIFEST <br /> ■ �Y� ■ WARS e WASTE TREm MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. - <br /> SHR 6 <br /> GENERATOR - REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> S7GL1bA � UCKINNG , INC. ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILIN ADR_ ❑TY-VEK ❑OTHER <br /> 2119IALPINE AVE . SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,21r <br /> ' STOCKTON, CA 95204 <br /> PHONE ' <br /> {2C9� 982-1114 <br /> CON ACT P RSON - <br /> DAVE SILVA <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> i <br /> I <br /> • WASTE TYPE REGEIVI;G FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [� DISPOSAL SOIL ❑ WOOD gggg SOUTH AUSTIN ROAD <br /> r_1 CONSTRUCTION SOIL r-1ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 36 W. MATHEWS RD . (209) 982- 1009 FAX <br /> FRENCH CAMP, CA <br /> NAME NOTES: TRUCK NUMBER <br /> RICH HA*-dITLON TRUCKING <br /> ADDRESS <br /> 1336 APULINE AVE . <br /> CITY,STATE,ZIP <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (209) 578-4100 MX ❑ ❑ <br /> _ SIGNATURE�QF AUTHORIZED GENT ORD R DATE ROLL-OFFS) FLAT-BED VAN DRUMS <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 DI POSAL 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 _ .BIO AERATE S70CKPItE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on L <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 accep <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNAT E OF / ORIZE/(p/AGENT // LDATEASH <br /> \/ <br /> 0 F OTHER <br /> SCHEDULING MUST BE MADE PRIG 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 MANIFEST # 14765 <br /> TRANSPORTER COPY <br />