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t <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WARj D WASTE TREATMENt AND DISPOSAL FACILITY <br /> i <br /> ►NC. JOB ACCEPTANCE NO. <br /> GENERATOR "' "`;, r = ' 'i!"'' ."• ` r. v�;;: REQUIREb FER_SONAf 'PROTECTIVE EQUIPMENT <br /> To ota. Towri E]GLOVES []GOGGLES ❑RESPIRATOR ®HARD HAT <br /> MAILING ADDRESS K" xi , r';��: M, '`' ❑TY VEK ❑OTHER <br /> P.O. 1'6x 6 30:36 <br /> *" IP, 'tz T~� t`� SPECIAL HANDLING PROCEDURES: <br /> •_ CITY;STATE;'ZIP, �� P� � "�� ��' ,< <br /> a Stuckton, CA 95202 _._ <br /> OHONE <br /> n PERSON,. a,. - x{:-. <br /> Parlciy Peytto:l.cl, w ; <br /> C. l Sciil. Code <br /> 81GNATt�RV O AUTH ]ZED NT /.TITLE", DATE: �: ,I,;, E. <br /> 3/ 3 <br /> WASTE TYPE RECEIVING FACILITYX,rl <br /> r <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> E] DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> + ❑ CONSTRUCTION SOIL ❑ ASH <br /> T <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY, (209) 982-4298 PHONE. <br /> ` oyotrt ` cr..,Tri of Stockton (209) 982-1009 FAX <br /> AME , . - NOTES: TRUCK NUMBER- <br /> Jim Thorp- Oil, Inc. � = <br /> r ` ADDRESS . . <br /> P.O. Box 357 _ <br /> rt+ CITY,STATE, rZIP <br /> - – <br /> �.cn 05241-03117 <br /> - PHONE „ END DUMP' .ti ...__ ..$OTTOM <br /> 1� S ��',.: TRANSFEq� ,;. <br /> y1 O9 /I`Y'2—r4 F'1 © _ 0 1-1 <br /> w SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL�OFF(S) FL AT, .BED ,_ ,g.VAN DRUMS <br /> El El <br /> r,- <br /> FORWARD INC. LANDFILL CUBICYARDS, <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.;g °(TO.BE COMPLI:TEb,BY.FORWARDy <br /> impairs the safe and effective operation of the Landfill. Forward shall use I M PL O ,. ..,, <br /> tr reasonable efforts to promptly notify Disposer of its inability to accept the } 's <` DISPOSE * BIO : A TIS $1OGKPItE OTHEt , <br /> Y <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> [1 weather or other site conditions, Forward shall notify the Disposer when site ❑ SOIL ' <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> NON-FMABLE <br /> ,PACILrf y TICKET:NUM$ER•..` ❑ ASBESTOS <br /> ❑ WOOD <br /> - s S .—^fir-_....;,Y... _,1. <br /> &KT_l1RE�OF AUTHORIZED AGENT - . DATE_: <br /> ❑ ASH <br /> - - ❑ OTHER <br /> F.C:1IEDIII_ING Mi_fST RE MADE Prurm T,o i:(IC) F,m. •11IF_ f_ y rT;1CJti TU ErXIPECTED AftfTIVAL ANY UNSCHEDULED LOADS ARE <br /> ci in,fr- .'T..T[) fTf f"�f� A[_lJr{?rt ArzrTl�nl_. 01`100 11`4 , 0AIL), t "-1_I�rr_-_r;tf:^ Pnl� 1 EZE SCl I►.OULED WITH THE LANDFILL THF DAY BEFORE. <br /> TO SCI IEFA)LE CALL (209) 982-4290 MANIFEST# 7868 <br /> 'rrlAf�st�r.�117T.:ft Ct1f'Y <br />