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1 . �,. � NON HAZ( 'DOUS WASTE MANIFEST <br /> • WAR WASTE UAl MENT AND DISPOSAL FACILITY <br /> INC. <br /> e <br /> r� JOB ACCEPTANCE NO. "` ss ,s` s }' ' m; " <br /> GENERATORi,, a ._ L„ t;=a_ c.� !;: . REQUIRED PE_RSONALPROTECTIVE EQUIPMENT „- <br /> f E Z RyE OF CALIF GLOVES ❑GOGGLES []RESPIRATOR E]HARD HAT <br /> 1 MAILJNG AbDSS_ iw ,tam tea', z HF moi., a ::., ❑TY-VEK ❑OTHER <br /> 922021 " - SPECIAL HANDLING PROCEDURES: <br /> CITYSI•ATZI r- r� <br /> • HOUSTON, TEXAS 77292 2021 -PH <br /> rt,.,...., ; <br /> x.�..: <br /> 7 684 4312 4 <br /> w <br /> CONTA RSO_N S. K. 'i::> ....'a" 'r.•.. .<.:::� <br /> R JIM SHIFLET__ F <br /> i SIG E OF AU_THOR_IZEDwAGENT/.TITLE ,,,_ DATE <br /> f * �l <br /> 4 RECEIVING FACILITY _, <br /> • WAS E TYPE <f. .. __ . <br /> ❑ SLUDGE ,.. <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ wOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH - <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • <br /> GENERATING_FACILITY (209) 982-4298 PHONE <br /> 239 S. STOCKTON ST. (209) 982- 1009 FAX <br /> RIPON, CA <br /> iNAME - ii ,. . ._NOTES ;;I TRUCK NUMBER <br /> p��H HAMILTON TRUCKING -d <br /> ADDRESS <br /> • CITY,jai,P.fliouLINE AVE w LOAD #5 <br /> r1 _ <br /> PHONEODESDT,CA 95358 ,, Inti - END DUMP, BOTTOM DUMP TRANSFER <br /> 5 <br />{ (ppg 57g g1np ❑ El <br /> DRUMS <br /> SIGNA46RObF" 8 H_ 8Rl4ED-AGENT OR DRIVER DATE _ ROLL F(S ,-FLAT-BED VAN <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlcvARDs;,, <br /> Forward shall have no obligation to accept the waste if weather or other 15 C. YDS - <br /> 1 conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD ', (TO BE COMPLETED BY FORWARD) <br /> impairs the sate and effective operation of the Landfill. Forward shall use . .,. DISPOSE -:BIO AERATE STOCKPILE "OTHER <br /> reasonable efforts to promptly notify Disposer;of its inability to accept the _. -. ._. <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 /> • REMAR_KS Ei NON-FRIABLE - <br /> I ASBESTOS <br /> I- FACILITY_TICKET NUMBER{�' R „i; .. WOOD <br /> SIGNATOR OF'AUTH RIZE'D,�'A <br /> q ❑ ASH -- <br /> ���� I ❑ 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 MANIFEST# 14734 <br /> '� rAeucpnorco cnov <br />