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•, <br /> WARD <br /> NON-HAZ� �UUS WH5I tMHivIrt�i <br /> WASTE TRE RENT AND DISPOSAL FACILITY <br /> 711 <br /> 4 JOB ACCEPTANCE NO. . <br /> GENEFtATC?R EQUIREfl PERSC}NAt PROTECTIVE'EQUIPME[dT <br /> ❑GLOVES E]GOGGLES [:]RESPIRATOR ❑HARD HAT <br /> PR,ODUC.TI.OJV--CAR-PA��.....,�....�Y .,.-. TY-VEK ❑OTHER <br /> MAl1WG ADDRESS ❑. <br /> 1.000 E...___CHA NES- - .,--•--- - -�r------ <br /> CCTV,STATE,ZIP ,-- SPECIAL HANDLING PROCEDURES: <br /> _ <br /> • �. STOCKQ�_N_� C_A_ 952.05 — � <br /> PHONE <br /> 209=943-7337 :, a� <br /> CONTACT PERSON <br /> PHIL . BOLER <br /> SIGNATURE OF JAUTHORIZEDAGENT ;TITLE DATE <br /> Z—Z <br /> WASTE TYPE RECEIVING FACILITY b <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ® DISPOSAL SOIL ❑.N WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH t <br /> .. ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4.298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESS :qqo <br /> 1336 PAULINE AVE . LOAD #10 <br /> . CITY,STATE,ZIP <br /> MODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP i TRANSFER <br /> 209-578-4100 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc YARDS <br /> • r <br /> 4• <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 SOIL <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 <br /> the waste. ❑ SLUDGE <br /> ` REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGN�TURE OF AUTHORIZED AGENT DATE <br /> _ ❑ ASH <br /> * � 5 <br /> ❑ 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 5497 <br /> TRANSPORTER COPY MANIFEST # C <br />