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NON-HAZARDOUS WASTE MANIFEST FOR'L��.D __ . — NONHAZARDOUS WASTE MANIFESTFORWARD ,HASTE TREATMENT AND DISPOSAL FACILITY I N C O R P O R A T E D �rASTE TREATMENT AND DISPOSAL FACILITY INCORPORATED JOB ACCEPTANCE NO. ` JOB ACCEPTANCE N0. awdm[]GLOVES []GOGGLES❑RESPIRATOR ❑HARD HAT Prr^ LXK6 ❑GI OV K []GOGGLES❑RESPIRAT 1 ©HARD FL4T � LA ❑TYYEK ❑OTHEp f ❑TYVE []OTHER - D SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES N VO C L • i � OqkETFofnHORt n"�r>t rr�Tar_» DATE WASTE TYPE p SLUDGE ❑ SLUDGE FORWARD INC LANDFILL . ❑ [3TREATMENT SOIL NON-FRLABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS • 0 INSPOS&Soy ❑WOOD [)DISPom SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑C0NMUCTIONSOIL ElASH 9999 SOUTH AUSTIN ROAD [] CONSTRUCTION SOIL ❑ErOASHER S � CALIFORNIA 95336 [�QTHER s�-�� MANTECA,CALIFORNIA 96336 • �4 �,Le MANTECA, • GENERATINGFACRf1Y (209)982-4298 PHONE GENERATING FACILU,_. _ _ - z -=y� (209)982-4298 PHONE (209)982-1009 FAX (209)982-1009 FAX NOTFr8 - TRUCK NUMBER Pq NAME .� _ NOTES TRUCK NUMBER NAME � 21 t{ - )-D P l�c ADDRESSADDRESS ' _ �6 Qa ('3� . sU alt�r Aar �tc31��'J GETI'STATE TIP . CITY STAT3 M tST� t La . ��35`3 , PHONE �^,rJ\ 5�� ( CA 4i~•� ,EN M1MP_ BOTTOM DUMP TRANSFER END DUMP BOTTOM IOM DUMP TRANSFER Irvi`) S r^ I PHONE LLr� �_ +� ❑ ❑ SIGNAT AIIiHORRE/D NFPIT OR DRIVER DATE ROLL (S1 FtAT-BED VAN DRUMS SIGNATI]RE OF DAG N7 OR DRIVER DATE ROLL-OFFS) FLAT BED VAN DRUMS ! C] ❑ ❑ ❑ CUBICynppg, ' FORWARD INC LANDFILL +c Y'l�17p' FORWARD INC.LANDFILL "'k°x1 Forward shall hm no oba0atron tO acnol the waste d weather a Other Forward sten taw m obapetlon b accept Vm waste it waader a otter ` L' condn"m Inpav or safe antl elkctw tlnoosal of the waste Or d the w"ll DISPOSAL MOOD' (Tp BE COMPLETED BY FOROARD) carddloru mvmr the Wit"CIIeCMe ompo"of the waste or d the wase DISPOSAL METHOD' (TO BE COMPLETED BY FORYUARD) srparrs the We and eflact"operator of the Lmdldl Forward was use -4 , y� �FiATE OTHER erpws ase sale and eNechw operation d the LerdU Forward Shea use / Bb AERM 3MC4 aE OTHER reasonWA cribra b pompty noldy Drappser d its eadatY to accept the tiN; _ - nasorabis eflorb to ptlMPCIr n0irfy Daaesw CO its kadaty 10 accap the waste for airy reaaan a Forwards refuse W accept the waste n based On waste tar any rassoa If forward s refuse!to aocapt 0e waste a!rated an �� weather or otter so co dmom Forward shat notdy the D wmr when are L.1501L rwalher or otter ads cordarpns Forward shad no*IM Deposer wlam oda LI,"4 conddure ars exoacetl to chugs such that Forward w N be tole b accept conditions are expected to charge such that Forward will W able to ecceM , Be waste ©SLUDGE ate waste ❑SLUDGE w REMARKSNON • REMARKS NON FRNBLE ❑ASBESTOS FACIUT"CK{T`f NUM*ER/- r r I I ❑WOOD FACiLIT)/TtC+CFjf NUMBER �t J I ❑WOOD OR` AG I /E � WOOD0 ASH SIGN�fTUR AUTH - ! � iASHt' ' ✓ ©OTHER t t i y 0 OTHER SCHEDULING MUST BE MADE PRK)R TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO X00 P M THE DAY PRIOR TO EXPECTED ARRfVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL O400ONGOING DAILY DELIVERIES PFIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ON141CING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY/B�EFFjORE SU SCHEDULE CALL(200)982-4208 HE LANDF• H 53050 TO SCHEDULE CALL(200)082-4208 MANIFEST, 5 3 0 4 7 / GENERATOR COPY GENERATOR COPY