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NON-HAZARDOUS WASTE MANIFEST FORWARDNON-HAZARDOUS WASTE MANIFEST I N C O R P O R A T E D ATE TREATMENT AND DIISPOSAFACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACHM JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. CHH — 4402 _ �L _ _.s`u. :w- +i >� �Y _'w+ y = _REOUIFIIEOPIEFSO ALPFZMCTNEEOUIPMENT - L • ❑GLOVES ❑GOGGLESEIRESPIRATOR ❑FWiDHAT ..__ _ �,, ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT p0 0 7 ❑TYVEK ❑OTHER MAS A m_fay.sa.s ., Q TY VEK ❑OTHER ti � r Y SPECIAL HANDLING PROCEDURES i' EO' �7 AYa SPECIAL HANDLING PROCEDURES GTg OONIAGJ PERSONS,� ,,r *+a.-•3r 0P7 5RB1�.^5�73-Y rr�q �a:CONMT _ JA �RI7)ry fT•s.6 iter srkC n i ' " SIGNATURE NT/TTTLE' DATE SIGNATURE � GENJ/TITLE DATIE ^ %.✓' f�`fG �� WW17E TYME _ �� RECEMNGFACLffY_ RECEIVING FACILITY ❑ SLUDGE ❑ SLUDGE © TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL E]TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ' ❑DISPOSAL SOIL ❑ N+OOD 9999 SOUTH AUSTIN ROAD • ❑DISPOSAL SOIL E3 WOOD E] CONSTRUCTION SOIL ©ASH ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD _ gOTHER s-tocKp,L.r MANTECA,CALIFORNIA 95336 p OTHER MANTECA,CALIFORNIA 95336 GENERATING FACLMY (209)982-4298 PHONE GENERATING FACILITY (209)962-4298 PHONE (209)982-1009 FAX (209)982-1009 FAX NAME NOTES [—TRUCK NUMBER NAME NOTES TRUCK NUMBER �7 Cir q?C! 7 4- P �l J ADDRESS Zo P� 16 - ADDRESS 1.3-3 /Pa//�✓'/�dL '71; CJTY SLATE ZIP + J r- - .CITY STATE ZIP PHONE ENDr BOTTOM DUMP TRANSFER r7F-�iia� ❑ ❑ PHONE END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFIS) FLAT RED VAN DRUMS 1f L_i7 --14gi ©x ❑ ❑ ❑ ❑ ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT BED VAN DRUMS c� ❑ ❑ ❑ ❑ FORWARD INC LANDFILL �"B'C YAMS FORWARD INC LANDFILL CUBIC YAFlos Forward shell ham no obigatrwr to aCCepl the waste It wealher or other f conditions eparr the Safe and eftect.re dadosaf of the waste or J Ire waste DISPOSAL METHOD (TO BE COMPLETED BY FORV"D) Forward sites haw do oblgatpn to accent the waste d weather or Wier ly morass the sale and eflectm ooerstlon of the Lardl,a Forward"il Ase rvrddare■rpalr the eels and eflectne datmeal W the waste or Y the wails rm&vsAr L METHOD' (TO BE COMPLETED BY FORMRD) randrAtte efforts to Wompity nerdy Disposer of es UM.Lty W accept the B10 ATE SMCXPLE OTHER erpaae the Sete and aNedwe operalm al the Landfill Forward&hate use waste far any reason N Forward s refuaat to accept the waste s based oil reaaddaNe efforls to promift nod Ddposer d as WWAIy to mopeds the Bio JAERATE STCC0111 OTHER weather o+other ane condlhons Forward shoe notifythe Disposer vAw ute E)SOIL waste for any reason d Forward a rek"to accept Ite waste a based dot carddons are expected to Change soon that Forward will be able to accept weather or other ane wrddrons Forward shag ro dy the Deposer when arta ❑SOIL the waste ©SLUDGE cord bDns ane expected to change such that Forward wra be able to accept I ` REMARKS "waste ©SLUDGE • REMARKS —17' ©_ASBESTOS ❑N.FolaaE FACILITY TICKET NUMBER FACILITY TICKET NUMBER' '-:rc'M14 -~... �- ❑WOOD �.a _ © SIGNATURE ADT1i9RIZ1:[?,AGE4T7 D5E WOOD r E]ASH SIGNATURE �1GEN� � DATE' _ '~ �` ❑ASH 7t `' - []OTHER 77 __,HER SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED VATH THE LANDFILL THE DAY BEFORE SCHEDULNG MUST BE MADE SUBJECT ITT}REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SE DAY PRIOR TO CHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(Sop)082 4298 MANIFEST. 53019 TD SCHEDULE CALL(209)982 4298 MANIFEST 1 55524 GENERATORCOPY