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i INVi i i i kl• � � � �� f war �� iw�� \U Omvmc-gKat••- yi n n FORWARD - NON-HAZARDOUS WASTE MANIFEST ORWARD NON-HAZARDOUS WASTE MANIFEST -INCORPORATED WASTE TREATMENT AND DISPOSAL FACLITY4 1 N C O R P O R A T E D Wpm TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. -� AMES LAN STON ❑GLOMES GOGGLES RESPIRATOROHARDHAT ` JAMES~M LAIIGSTOIt+ []GLOVES ❑GOGGLES❑REWR40A ❑❑HARD HAT ❑TYVEK ❑OTHERC .�. ©TYVEK ❑OTHER P O_ BOX 97SPECIALIiAIVDUNL PROCEDURES P 0 BOX _97 � _4 Y T_ ��rrr $pECL4LHANDLINGPROCEDURES CITY +..__ + tATHROP CA 95330 LATHROP, CA 95330 PHO t 209-957-5981 2CS-957-5981 CON%WTPERSON JAN HENRICKSON JA.' 4EIAFIICKSO ' H _ SIGNATURE OF AUTHORIZED AGENT/TITLE r DKrE REOE1 Jfa^ AGfJiY VOSTE TYPE RECE]YQIM FAClfY ' [3 TREATMENT SOIL p NON FRIIABLE ASBESTOS FORWARD INC LANDFILL [:] SLUDGE FORWARD INC LANDFILL ' �TREATMENT SOIL ❑NON FRIABLE ASBESTOS ucrOroLNSOIL wow' 9999 SOUTH AUSTIN ROAD ❑DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD [3 OTHER STOCKPILE MANTECA,CALIFORNIA 95336 _ coNsrRucTfoNsaL 0°ER ;71'i- MANTECA,CALIFORNIA 95336 GENERATINGFAGUTY _ _ _ (209)982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE LA';STO'1'S BATT £ TACKLE (209)982-1009 FAX 1- =*� " - -T - (209)982-1009 FAX 15'15 SEVENTH ST I- ' :�= h- T LATHROP, CA LmT--:Vj?, NAME _ _ - - _ NOTES TRUCK NUMBER NAME NOTES TRLICK NUMBER �11 kiAAiLTOtY Tr7UC1:Id.^i yJ ADDfi�S�u, 'iA ii.Tu^^,. �r��ULINE AVE. - LOAD 252 - - - .cmr's'ii+T'� f115.,s7. ' 11 -4 moNr ZESTO CA 9535IIJ_+Jt Ca �� r END DUMP BOTTOM DUMP TRANSFER END DUMP BOTTOM DUMP TRANSFER gfONf�' 99��❑❑ Q�pp ❑ ❑ - 7r SIGEl �}TORIZED AGENT OR DRIVER DATE ROLL�OMA FLATBED VAN DRUMS S�,NATUREFIF AUT1�aF TED AGENT OR DRpER) DATE ? ROLi�FIS► FIAT BED13 VAN DRUMS � / ` 11 0 ❑ ❑ ❑ ❑ r RDS CIJSIC FORWARD INC LANDFILL `x' Yd` - - FORWARD INC LANDFILL Forward"he e rho OG4Pbm 10 accept the waste d weather or other r l Forward Shall have e0 ebigation to accept the waste d weather or other co dithorle mpae the sate and elfettre AmDoaat of the waste or d the waste DISPOSAL METHOD; gO BE COMPLETED BY FO MM) cond4.an mpamr the ute am etlecthve o.sr osw of the waste or d the waste DISPOSAL METHOD LTO BE COMPLETED BY FORWARD) orpws the sale and effectwe operabon d IN landfill forward shall wewpaas the sate end eiecave operaboA 01 the Landl.R Forward shall use B10 AERATE 510Gh�aE OTHER reasonable etlbrts to Promptly notRY Deposer d"mebhlhty 10 SOCW lila AERATE OTHER reasonable efl«Is to promPlty 110111Y DuPdseh of its mabdlly 10 Accept the DISPOSE waste Ior arty reason a Forwards relusar b except Re waste a basedm waste f«arty reason d Forwards rehrsal l0 accept the waste is based on ❑SOIL weather«other site omartions,Forward shall rotdy the Disposer when ante C1SOfI weather«other site rArrilans Forward smallrh0ldy the Deposer when dle hor44mns ars egnood to charge each Nal Forward who be able to accept Caldrons are expected to charge such that Forward will be able to ACCapt 1te waste _ _ _ _ _a ❑SLUDGE the waste []SLUDGE + REMARKS _ ,� - _ _ _ -- NpN-FAUBIE + REMARKSi�NON FRMLE • ASBESTOS LJ ASBESTOS FACILITY TICKET NUMBER„ _.w _ _ _ � ❑YA70O FACILITY TICKET NUMBER ❑WOOD MNATURE OF'AUTNORT£Eb74 D&_ DATE ❑ASH SIGNATURg_0E-AGTHeRt'-E4A DATE �]ASH UOTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 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 TO EXPECTED ARRIVAL+ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY IFFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE GALL(2091262-4208 MANIFEST 0 53095 TO SCHEDULE CALL 12091982 4298 MANIFEST- 53096 TRANSPORTER COPY GENERATOR COPY