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NON HA��A DOUS WASTEMANIFEST <br /> WAR11 WASTE TRE 1ENT AND DISPOSAL FACILITY <br /> FW <br /> I C- -JOB ACCEPTANCE N0 ` , <br /> C' ... p '� .R✓ : .f.• :..3'.i :.r.+..W:: v..r-c_v ra.isiK.�.... � yyr ...a4P.'..}/" >E ?SI <br /> :.;., RP IREI� <br /> .r..+..... bie.F. '.ra+/ >�. "wn .? -0 '.S.r . <br /> Tw s "e <br /> P_RO.DUCLLOb,� A ❑GLOVES ❑GOGGLES 0RESPIRATOR. ❑HARD HAT <br /> MAILING%AP RESSy x .;; OT <br /> Y-VEK. ❑OTHER.. <br /> CITi;STATES ZIP_w _ ; " �T - - SPECIALHANDLING PROCEDURES: <br /> • $TOC TQ;.,_ CA.__9§.2Q5 ,. <br /> PHONE • <br /> 209,-943=7.357. <br /> CONTACT"PERSOU 771- --7 ,�.._ <br /> PHIL. 80LER <br /> SIGNATURE OF AUTHORIZED AGENT f 6lTLE. Di4TE 4 <br /> WAS11E TYPE <br /> RECEIVING FACILITI* <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ® DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> r <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • ip <br /> GENERATING FACILITY (209) 982_4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME. NOTES: TRUCK NUMBER <br /> RICH HAMILTON .TRUKCING <br /> ADDRESS <br /> 1336 PAULINE AVE. LOAD #2 <br /> . . CITY,STATE,ZIP ? - <br /> MODESTO , CA 95352 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 0 0 ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc 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 TICKET NUMBER <br /> ❑ WOOD <br /> SIGfGA�T`URE OF AUTHORIZED AGENT DATE <br /> Q.ASH' <br /> fT <br /> *�` �` �� �)S ❑ 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 /> TRANSPORTER COPY MANIFEST# C 5489 <br />