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�R�UAR� NON-HAZARDOUS WASTE MANIFEST ORWAR.D NON-HAZARDOUS WASTE MANIFEST INCORPORATED WASTE TREATMENTAND DISPOSAL FACILITY AiNCORPORATED WASTE TREATMENT AND DISPOSAL FAGiIlYY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. '2 ' JAMES M LANCSTOM []GLOVES ❑GOGGLES❑RESPIRATOR ❑HWDHAT M ❑GLOVES OGOGGLES❑RESPIRATOR ❑HARDHAT ❑TYVEK ©OTHER • s ❑TYVEK ❑OTHER P 0 BOX 97 SPECIAL HANDLING PROCEDURESP B0�_,q7 , }z SPECIAL HANDLING PROCEDURES Tom • +Y LATHROP, CA 95330 LA3.`4 209-957-5981 _ 2.09-957-5981 �+�,w t=t'Z+�"'!R PERSCNI+s �`7Ys.aCaai.� CCINWCf PF�SOt��'atG-•��. �• � ��_ .�+w.rll�i:sa, JAN HVIRICKSON JA" I ESjRICC50'4 S dW mjRE OF AGFNT T"T DATE -rr— SIGNATURE OF AUIHOF»D AGENT!TITLE 1744701,71 c .� c5 , : � WNSTE TYPE _ RECEIVING FAC9.fT1_,"_.a,a„_ _ a _ •• VOSTE TYPE ,° 1 1.., RECE II FACiJTY _ SLUDGE ❑ SLUDGE FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL Q NON FRIABLE ASBESTOS p DISPOSAL SOIL ❑viom9999 SOUTH AUSTIN ROAD ❑ DISPOSAL SOIL © WOOD 9999 SOUTH AUSTIN ROAD 13 CONSTRUCTION SOIL ❑ ASH ❑ CONSTRUCTION SOIL ❑ ASH ©OTHER STOCI'I_LE MANTECA,CALIFORNIA 95336 _ ❑ OTHER ^Tr';;V tLr MANTECA,CALIFORNIA 95336 GENERATING FACILITY (209)982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE LAIl,srn,1.3 RrTT v TAClLEt-�' 170 `` n `T T,C'L 209 982-1009 FAX 1�C1� 5=tie T� 5T (209)982-1009 FAX ; ,6IT:' ST { ) LATvR7?, it 0. NAME �g TRUCK NUMBER NAME NOTES 7RU�IG�JUlIBER {;, HILT ff TPUC41 f �-♦'I -4�1'ILTq y TRUC ING C1 3!� 3�� I C C G ��7.r//3 CA ADDRESS I�, T 3 ADDIU 1322 D n f E ,is L 1n0 -3 I -- ' CITY SUITE ZIP .err STATE,ZIP � � r -- _. • PHONE--- -' END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER T1 ❑ ❑ ❑ 2- --7 -31" Q ❑ ❑ AN DRUMS SIGNATUEiE jiF AUTHORIZED AG NT OR DRIVE DATE ROLL OFFIs} FLAT BED VAN DRUMS SIGNATURE OF AUTHORIZED I NT OR DRIVER DATE ROLL-OFF(S) FLAT-BED ❑ 11 D 11 El FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL cuBICYAy:EIs, Forward nJ,sa nava rn ebhpahon b axes the waste sl w..uer or akar Forward ahaarine no oblMation to aceeol the waste a wealhen a Clow( / c"dionn wow aw seta old etfeatrve O,suoesi of the waste o a the waste DISPOSAL METHOD' (TO BE COMPLETED BY FORVAWRD) condmorth el&We a uta and opefattlecirm daeout or uw suede a d the waste DISPOSALMETHOD, ITO BE COMPLETED BY FORVV/WDI enpeua the safe and df,.opera.a the LardhY Farwand"use angarra the safe aro auecWe operalon o Inw 6"jn Forward shay,we / �13TO� OTHER reasonable 011"to pr"tV nohfY D,seasar d ea Inab&Y Ie accept IM SFOSE 8l0 AERATE slOca+'se OTHER reasonable ny res b proForw Forwards r DaPoser a pi rwhwa o abase[9w Ork waste for any=am I Forward s naanal to ectad the wale a based an waste to any mason Y Forward a nNard to not4ccepi the waste of when to weather or other sde condrtau Forward ahaa notify the Droeeaen wten arta IL weallwr or drat ase eonddrons For sows noldY the prsooser when yle cordiuot4 am amecod to own oe such UW Forward surd be abie to accept corlm or s are exeectecl to Change such that Forward w,G be aW to sed me waste ❑SLUDGE de waste ❑SLUDGE w REMARKS ` ASBf REMARKS i VBLE AS FRPBI.E ❑ASBENON-FRSTOS ❑ 5705 FACILITY TICKET NUMBER I FACILITY TICKET NUMBER ❑WOOD ❑WOOD SIGN�rfU jOFTHORIZED/GENT / H SIGNATt�Rf`O AORIZED ACyEkT 1/ DATE ©ASH i �Z.J '= yr ❑orHER of El OTHER SCHEDULING MUST BE MADE PRIOR TO/440 P.M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TOEXPECTED BEHE SCHEDULED W+ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL,ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE Tb SCHEDULE CALL[209]982 4298 MANIFEST w 53077 TO SCHEDULE CALL{209)982 4228 MANIFEST a 53078 GENERATOR COPY GENERATOR COPY 1