|
tR`lFtNn, OY, Nf rHAT'rrPDt yiO�k Ur-0yS WASTE MANIFEST
<br /> "Ar. WARDWASTE kAMENT AND DISPOSAL FACILITY
<br /> Ot + ruE
<br /> � €
<br /> REQUIREDRERSONAL PROTECTIVE EQUIPMENT ?
<br /> E.Z SERVE OF ,CALIF [:]GLOVES ❑GOGGLES [:]RESPIRATOR ❑HARD HAT
<br /> MAILINGI
<br /> ,ADDRESS ? a
<br /> J. =e ^`" r t' 4 'F "
<br /> .a us .at �. . LT.c ,&.�7),�r� []TY-VEK ❑OTHER
<br /> R.0—BOX 922021 f
<br /> ^a; , , n�-�* ti 7.� ,: �F SPECIAL HANDLING PROCEDURES: -
<br /> CITY STATE ZIP e ' r
<br /> • HOUSTON, ,TEXAS_77292-2021
<br /> 684 4312____ r n
<br /> _ 4R . JIH SHIfLET 'k
<br /> SIG TU OF,AUTHORIZED AGENT/:TITLE _S_„',':'DATE rv;, is i
<br /> WAS RECEIVING FACILITY `
<br /> f
<br /> ❑ SLUDGE
<br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL .._
<br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD
<br /> E] CONSTRUCTION SOIL El ASH'
<br /> ❑ OTHER
<br /> MANTECA, CALIFORNIA 95336
<br /> GENERATING FACILITY (209) 982-4298PgHONE
<br /> 239 S. ' STOCKTON ST. (209) 982- 1009 FAX
<br /> RIPON, CA
<br /> e' y _ - NOTES
<br /> NAME..:.; .....�: :. ` _.� ,...:. .,:_.e_.�_ ... :., <I_ .....,,.... .,_.,___ .. _....,.. ,. .. _.._ ..
<br /> PiRN HAMILTON TRUCKING t,� v
<br /> ADDR __ .. _-... ...
<br /> .1336 PAULINE AVE LOAD !t12
<br /> •
<br /> CITY,STATE,ZIP_.;,,, , ?„ __.._ .'=;t -. •. -• -�
<br /> NODSTO,CA 95358 - END DUMP ': 'j',- BOTTOM P ,
<br /> ❑MDUM ,_._ TRAN❑SFER
<br /> PHONE..'t Iy�p -
<br /> SIGNATURE�Of578T4100 ED AGENT OR,DRIVER_; DATE . _ ,. ROLL OFF(S),';_r- FLAT-BED VAN DRUMS .
<br /> FORWARD INC. LANDFILL cua(c vAROs, ;,
<br /> Forward shall have no obligation to accep('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. Forw d shall use DISPOSE RIO AEf?ATE STOCKPILE 'OTHER
<br /> weather or other site conditions,Forward shall cc its inability t o accept the -,, .:,- - ._�,. _ . . - - -
<br /> reasonable efforts to prompt) notif Disposer
<br /> waste for any reason. If Forward's refusal to accept the waste is based on r
<br /> notify the Disposer when site
<br /> conditions are expected to change such that Forward will be able to accept
<br /> the waste j ❑ SLUDGE
<br /> NON-FRIABLE
<br /> 10 ASBESTOS -
<br /> FACILIT(-TICKET NUMBERr� " t 'st s T'
<br /> .. -.r __ ::'tk✓,J.,.�_.-=:. .4 __ ❑ WOOD
<br /> SIGNAT F I ORIZFB'�GE�(IT , �x ` -' DATF�, _ F
<br /> E] ASH
<br /> 7A - L! ❑ 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 # 14741 .
<br /> TRANSPORTER COPY
<br />
|