ARCHIVED REPORTS_XR0009703 - Laserfiche WebLink

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qD4�CS WASTE MANIFEST WNT AND DISPOSAL FACILITY ARD JOB ACCEPTANCE NO. �* ET G NERAT4Hc � - N=EQUIPMENT RI • -0L CI Y OIL COMPANY ti ❑GLOVES [:]GOGGLES []RESPIRATOR HARD # MAILING ACW$ft LAKEW09D4 ••• ❑TY•vE1C []OTHER ?�EY,CA 90240 - -- CITY,STAT Ik .- SPECIAL HANDLING PROCEDURES PHONE COACT PERSON RAYMOND FRSE'DRICHSNN� " � SEGNAT RE OFIUTH IZED AGENT / TITLE- DATE WASTE TYP w W RECEIVING FACILITY . . 4 #t t a : �RF-ATMEliBOIL [3NO€�3�RIABLE ASBESTOS FORWARD INC LANDFILL • WSPOMMOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ,. CONS Tj)N SOIL ❑ ASH ❑ OTHER MANTECA, CALIFORNIA 95336 r _ frWRAT i (209) 982-4298 PHONE (209) 982- 1009 FAX ST:C:'TON , CA NAME r,M �, Tn�t 1✓ R^�►'YiT A �^ NOTES TRUCK NUMBER ADDRESS •• CITY, STATYfI�^IJ5{3R CA 95 492 PHONE ry 3� ar END DUMP BOTTOM DUMP TRANSFER ❑ ❑ ❑ SIGNATUj E OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ FORWARD INC. LANDFILL CUBIC YARDS Fomard shall have no obligation to accept the waste if weather or other conditions impair the safe and effectrve disposal of the waste or if the waste DISPOSAL METHOD impairs the safe and effective operation of the Landfill Forward shall use {TO BE COMPLETED BY F reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE E00 AoAtE waste for any reason If Forwards refusal to accept the waste is based on =- - weather or other site conditions Forward shall notify the Disposer when site IL �i conditions are expected to change such that Forward will be able to accep - the waste ❑ SLUDGE - REMARKS - -- -- ------- - -- NON-FRWBLE - ❑ ASBESTOS -' FACILITY TICKET NUMBER ❑ WOOD SIGNATURE OF AUTHORIZED AGENT-- _ DATE -- i K „ ❑ ASH ❑TOTHER - I SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL TO SCHEDULE CALL {0909$2-4298 ONGOING DAILY DELIVERIES MUST BE SCHEDULED�TM MANIFESTHE LANDFILL g g gRE � GENERATOR COPY