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NON-HAZARDOUS WASTE MANIFEST NON-HAZARDOUS WASTE MANIFESTORWARD YIASTE TREATMENTAND FACILITY� W� , INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY CORPORATED JOB ACCEPTANCE N0. / JOB ACCEPTANCE NO. SRESOR WtOHATGVER ©GOGGLE []GLOVES []GOGGLES[]RESPIRAMFI HARD HAT JAMES H LANGSTON ❑ ❑TYVEK ❑OTHERT P OK B O% 97 SPECIALHANOUNGPROCEDURES SPECIAL HANDLING PROCEDURES ��P��C iPi!f[i41Pr� DATECA�9`�330 iA kr `9r 330 n7" 209-957-5981 209-957-5981- 09-957-5981 � JAI' yEuf;ICKSO?� JAN HENRICKSON _ _ AGtTIT%ITTLE„ DATEr _OF:*7m STE TYPE _ _ RECEIVING FACUTY�-t_ _ _ � V STE TYPE _ __ - � �_ REGETVNG FAC9ITYM YW ©SLUDGE ❑ SLUDGE FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON-FRIABLE ASBESTOS ` ❑DISPOSAL SOIL 01NOOD 9999 SOUTH AUSTIN ROAD ' ©DISPO5AL soy ❑ WOOD 9999 SOUTH AUSTIN ROAD L] CONSTRUCTION SOIL ❑ ASH ❑CONBTRUCTIoN sat_ ❑ ASH 0 OTHER STOCKPILE MANTECA,CALIFORNIA 95336 ❑OTHER 'STOC MANTECA,CALIFORNIA 95336 • GENERATING FACILITY (209)982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE LA 'u5T`I "S 9AIT r T,-rYi (2q9)982-1gg9 FAX L�v�STJ r "s e-_ TA:.I_- {209)982-1gg9 FAX 1FC_r Sc It 71- :7 1501=S 501= --VIPIT&I ' T LATHROP, C'A I _ATH Or', CA NAME NOTES, TRUCK NUMBER I NAME NOTES — TRUCK NUMBER �ywA tailSrLTOr' TRUCYI'iC i y � +`/' _ 'TC-' 4A 1,Tr1r6 TclUCK!"l) ADDRESS I I ADDRESS I:Sty DAULI4IE A11P Lt7A J 133c AR' LIOE ['E LAC" �� CITY STATE.ZIP CITY,STAT�-L� CA75,;89 JlJJ�l�-=� ) I'STj' � �I ~ ' D DUMP BOTTOM DUMP TRANSFER PHONE END Dl1A1P BOTTOM DUMP TRANSFER PHONE ENfh--1t, ❑ Cl r )g-s7^-a.11i Qr ❑ ❑ RUMS �{GNATURE�OF AUTHORIZED/}Ca`ENT OR DATE ROLL-W(S) FLAT BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR ORIVER DATE ROLL❑#F(Si FLAT-BED A 13 ❑ 7G FORWARD INC LANDFILL c"�c/Y FORWARD INC LANDI=ILL 'B`c YARDS .� Forward WW hays no d*pbon to accept the waste 4+wether or other ! 1 7 Forward thea Mw no aMgahon b accaM the waste d weather Of dha Cpldtorm crow Ora sale aro dfecaw dmposa!of Om waste a d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORVOPPi • wrow o the""sex the qte and Mauna n of disposal d the waste or d the wase p�SPOSAL METHOD (TO BE GOM?LETED BY FOF1VrV+Rp1 an ”"gale and rumdr a operation of the Lardha Forward ghat useJ rmpaws the aloe am dEmptlYemw oLdy on o! r L4S f Forward thea the g ,l OTHER reasonable efforts to pito, P'notdY Dmpoasr d as NUMV to mxvOl the BIO aAfRATE OTHER wase to lot re to proForw da r Oepaaer d ds W oraAIY a accept the waste for any reason a Forward s rakes"to&MOW the wast:a bated an waste for any reason a Forward a rehea!m accept Aha wase m based on [:]SOIL we8ther or other sae cordo aw Forward shelf m*the 0mpour when cele ❑SOIL wE8lher or otfmr arta COnddq[m forward Shan nddY the Deposer when sae corKmw4 an expected b chargta e ch that Forward oral be oble to accept ooj,44mu are expected to charst ge eh Inst Forward-H he able to accept the waste ❑SLUDGE Om wank , SLUDGE F a I e REMARKS ` ❑©NNeLE REMARKS © FRABLE i ASBESTOS FACILTTY TICKET NUMBER FACILITY 71GKET NUMBER ❑WOOD ❑WOOD SIGNATURE OF�HTFIORIZEQ AGENT`} srNAT ypE OF AUTHORIZED A6awjI _, N DATE --``} _ J ❑ASH ❑ASH OTHER E THEA MADE-PRIOR TO 400 P M TME DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4 UO P M THE DAY PRIOR EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST e SUBJECT 70 REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOaNG DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(200}982-4298 MANIFEST* 53085 TO SCHEDULE CALL(209)082 4298 MANIFEST* 53086 GENERATOR COPY GENERATORCOPY