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RWARD �- j-r- --- - AVON-HAZARDOUS WASTE MANIFEST � OR YYAR� NON-I-IAZARDOUS WASTE MANIFEST I ANC O R P O R A T E D WASE TREATMENT AND DISPOSAL FACILITY / WASTE TREATMENT AND DISPOSAL FAOLIiY }( INCORPORATED JOB ACCEPTANCE NO. - JOB ACCEPTANCE NO. /69mogmit4mu _ <_ MES�I, LA!1 STON ©n S GLESQRESPIRATOR ❑HARD HAT �� S_;:� pGIOVES ❑GOGGLES❑RESPIRATOR [3HARDHAT ❑TYVEK ❑OTHER af5,j-S D X ,,- -e- 4 SPECIAL HANDLING PROCEDURES � X q SPECIAL HANDLING PROCEDURES • LAT4R0Pt CA 95330 - -a..c---- - - PHONE?- + 209-957-5981 _ 209-957-59x8, CONpl,rpcparya'aa � �_ ii�T si CONTALrmRso r JAI' HPRICYSf? _ 7� JAI] HEdRICK501{SGTO AGE. � / E Xg *77M�7 1 WASTE TYPE " _ _ � F Y r _ yJA E w r. i RECENING Fi CIUITY - ❑SLUDGE ❑ SLUDGE • p TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL © TREATMENT SOIL ❑Nord FRIABLE ASBESTOS FORWARD INC LANDFILL ❑DISPOSAL SOIL ❑WOOD 9999 SOUTH AUSTIN ROAD p DISPOSAL SOIL ❑vvOCG ❑ CONSTRUCTION SOIL p ASH ElCoNSTRUCTIONSOIL ❑ ASH 9999 SOUTH AUSTIN ROAD _ ©OTHER 5T0C.aILF MANTECA,CALIFORNIA 95336 _ ❑ OTHER c—C'DILE MANTECA,CALIFORNIA 95336 GENERATMFACILITY (209)982-4298 PHONE GENERATING FAOUTY (209) 982-4298 PHONE Ln, 139TC' "S b VTT _ TACX=E I 'A r5 T I'- °AI7 T C �F 11,15 SEVE 'TH ST (209)982-1009 FAX , C-t,� ,T„ `T (209)982-1009 FAX LAT IF-011, ',A LST 'JOD C NAME NOTES TRUCK NUMBER NAME NOTES TRUCK NUMBER aT�I IlAll!LT0,l TRUCKI It _ - - �TC_j wA 17-LT04 TRLIrK:"IC t - ADDRESS C f' ADDRESS 332. P4!L`:E 04E LOAD A 2A, __'5 '"JL:': All- ;• �'�w� CITY STATE.ZIP rI - - 1-r - CITY STATE ZIP Wci -Or CA 0°3SS r3 __-I C '5251 • PSE END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER _!j4-57S-E1„In 0 ❑ ❑ ❑ ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZ,rEGA�gFrW OR DRIVER DATE ROLL-OFF(S) FLAT BED VAN DRUMS J J D Cl 0 13 11 13 FORWARD INC LANDFILL CUM YARDS /ICUBIC YARDS FORWARD INC LANDFILL , Forward shalt hags no obtgatron b accepl the waste d weather of other .... Forward slue haw no obligation b accept the waste d weather or other cortGhoru ulgarr the tate and effedwe doposW d the waste or d the waste DISPOSAL METHOD, (TO BE COMPLETED BY FORWARDI condlihons groan the safe and elleclrre dam”d the waste or d the waste DISPOSAL METHOD, (TO BE COMPLETED BY FORWARD) ■rpaea the Bala and MleCtrra operation of the Lartdite Forward Nue uaa SPOSE Bl0 JAERATE TTOCIBY OTHER rmpevs ins safe and effedne aperaton of the LAACIIA Forward stop use neasanabte Nforp to Ir�'r+xlY rtdtdy Dapoaer Of its etabdtty b accept the reasonable efforts a PrdrrplM,tobly DtaWser of as nalAty to eccao the SPOSE BID AERATE OTHER waste for arty Ma&M If Forward a refusal to accept the waste M based on waste for any reason a Forwards reluaal to accept the waste is basad an %"her or outer ode conditions Forward shag rWy the Deposer when are ❑SOIL water alfor other are"nadroru Hua notify Hnotify tna Disposer when sae ❑SOIL C id,illonis are expected tog�w such Nal Forward will be able b accept Conde+ona are O.peCted to charge auch that Forward wta be able to accept the waste ❑SLUDGE the waste r— ❑SLUDGE • REMARKS s ❑NON-FRIABLE • REMARKS ❑WM FRIABLE ASBESTOS 4RE905 FACILITY TICKET NUMBER © D FACILITY TICKET NUMBER _ _ ❑WOOD SIGNATURE'OrAUTHOFAZEI?V_E_k� DATE SIGNATURE OF AUTH19R62EO AGE j'D DATE ❑ASH _1-_ __�— / I A _ ❑ASH Q QTHER 7k _ f r THEA SCHEDULING MUST BE MADE PRIOR 70.440 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING193STHE MADE PRIOR TO 4 OD P.M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED MATH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)982-4288 MANIFEST* 53089 TO SCHEDULE CALL{2091982 4288 MANIFEST• 53090 GENERATOR COPY GENERATOR COPY