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+ �/� �®� I NON HAZ-`�DOUS WASTE MANIFEST i
<br /> /`� WASTE T r i MENT AND DISPOSAL FACILITY
<br /> �fNC. JOB ACCEPTANCE N0.
<br /> .615 ..
<br /> GENERATOR ,,, , , • , A „ ._,,: ., , ,: REQUIRED,PERSONAL_PROTECT)VE.EQUIP MENI
<br /> EZ SERVE _ ._,..,,,,
<br /> 'A ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARDHAT
<br /> �7F CALIF ,
<br /> El ❑OTHER
<br /> P..O BOX 922021 :� SPECIAL HAMDUNG PROCEDURES:
<br /> CITY STATE ZIP..':},., xs:ai�5 :nu..v.�._'� at.,.f.!..::.__..h..
<br /> HOUSTON, TEXAS 77292 2021 T ..
<br /> PHONE'>. •...._z.-.��..S.,r,��a...�.. >ir �.>s..:�; %�,,u.�sll�.
<br /> -..(7A3)—.68 74312
<br /> ys
<br /> CONE T RSON.,
<br /> M JIM SHIPLEY
<br /> SIG T E,OF AUTHORIZEO,AGENT/TITLE 'r '7 DATE , gY >
<br /> s
<br /> * E ► / q,
<br /> WASTE TYPE ,W�.. ._, .-. RECEIVING FACILITY a . .'z° . .. ..r. ... . _��
<br /> ❑ SLUDGE
<br /> ' ® TREATMENT SOIL ❑ NON'FRIABLE ASBESTOS FORWARD INC. LANDFILL
<br /> ❑ DISPOSAL SOIL ❑ w000 9999 SOUTH AUSTIN ROAD
<br /> ❑ CONSTRUCTION SOIL ❑ ASH' `
<br /> ❑ OTHER MANTECA, CALIFORNIA 95336
<br /> GENERATING FACILITY „ e >. (209) 982-4298 PHONE
<br /> 239 S. STOCKTON ST. (209) 982- 1009 FAX I
<br /> RIPON, CA
<br /> it I
<br /> NAME r::. .:... F.. 1. NOTES ? :TRUCK NUMBER
<br /> RICH HAMILTON-TRUCKING-
<br /> .........
<br /> ADDRESS
<br /> 1336 PAULINE AVE LOAD #9
<br /> • CITY,STATE,ZIP,.,,
<br /> MODESTO,CA 95358 , F
<br /> PHONE "" 4 sr, , _ END DUMP BOTTOM DUMPS TRANSFER
<br /> (209) _ 578-74100 ._ i �+ f
<br /> SIGNATURE OF THORIZ 'AGENT OR DRIVER DATE <."._ ROLL OFFS) FLAT-BED , ,;VAN DRUMS "
<br /> �^ 4 ❑ ❑ ❑ ❑
<br /> FORWARD INC. LANDFILL cuslc YARDS
<br /> Forward shall have no obligation to accept the waste if weather or other 15 D• YDS
<br /> conditions impair the safe and effective disposal sof the waste or if the waste DISPOSAL ME_THOD . s.(TO BE COMPLETED BY,FORWARD)
<br /> impairs the safe 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. ` _ E] SLUDGE
<br /> REMARKS. NON-FRIABLE
<br /> C ❑ASBESTOS -
<br /> FACWTY;TICKEfNUMBER `"t>r
<br /> ._srt::liz . .,.<..=..yr...ica_.�..:_......-_.. ......�:. ❑ WOOD
<br /> SIGNATUFjE QF IZED,AGE _ t DATE ".,_,
<br /> - �-.. . ...__. . ._ ... ❑ ASH
<br /> K
<br /> r �---- �' ❑ 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* 14738
<br /> TRANSPORTER COPY
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