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.�+ � w.�e ae�� sssssstffff� �� UB?• � Tf� � ! � ! ! !�� '.�. -i�� 1a 7�:ai R'41�= � ... •��"F��.tw7n' "'�.a11ZT JF'i�7 N• � �O� T - - - L�NDN- ATJ�RQOUS WASTE MANIFEST' �0� � ' x`k _ y�� N01 ' ►RDOCi �MANIFEST r 1 N C Q R P O Rid T'E D' `' "= waste TREATMEsuT Atm Sf�SA!FACILITY { r I N C Q R P Q R T E D ATE TIT Ar�O FACILITY •`� J08 AGCEPT,+4NC N0. »_ t JOB ACCEPTANCE NO. pGLOVES=❑GOGG S[]RESPIRATOR []HARD HAT k G (]GLOVES []GOGGLES[]RESPIRATOR QHARDHAT ❑TY*K ❑OTHER ❑TY VEK []OTHER SPECIAL HANDLING PROCEDURES t SPECIAL HANDLING PROCEDURES f1p. CA _?095 - Slt:�T.0 MAKS _ 51GWOU � WASTE'TYPEa^�"� '. 'S st v ar T RECEAIUIC3Fl1[7C[T3P' +w:!`e `..'•rr�U�!�=r els` 4WS7E ,^ k +rr'_' RECFIVRJGFAM7 �r ac}iT?tis SLUDG p TREATMENT SaL p oN�FERIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL p FRIABLE ASBESTOS FORWARD INC LANDFILL • Q DISPOSAL SOIL ❑ WOOD ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD E) CONSTFiucTXJN SRL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL p ASH QL,OTHER MANTECA,CALIFORNIA 95336 1 BOTHER MANTECA,CALIFORNIA 95336 • GENERATINGFAaLTTY (209)982-4298 PHONE GENERATING FACILITY . _ (209)982-4298 PHONE LA-SS T OW S BATT & TACKLELArIGSTC'I`S BAIT TAME (209)982-1009 FAX (209)982-1009 FAX 15615 SE ENT4 ST 15515 SEVENTH ST LaTHROP, CR t aTltlina ra NAME `_ �s::a..: - r _ IRUCK NUMBER NAME 5.e:a., d.x =,. , _ NOTES ...rte- y. sa. TRUCK NUMBER RICH HAMILTOU TRUCKING - _ W yf� y3973 ��r ADDRESS88 HP"I�LJQI�j9UCKiHG^ _� }C3136s 9c> ADDRESS ADDRESS _ - 1335 PAULIPIE AVE L)AO x!25 1336 PAULPIE ARE __ _ L087 „25 CITY STATE ZIP - CITY STATE ZIP YC-5'if- a 137ESTO, CA 95958 N f;, 7 H0O£STO, CP 95358 PHONE END DUMP_ _ BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER 219-578-4100 Qg ❑ © 209-578-41O0 ❑" © ❑ SIGNATURE OF AUTHORIZER DRIVER DATE_ ROLL-OFF(S) FAT-BED--- VAN - 'DRUMS SIGNATURE OF AU�TTIPRIZED AtiGENT OR DRIVER DATE ROLL-OFF(S) _ FLAT BED_ VAN DRUMS 11 0 D 11 cl FORWARD INC LANDFILL aIeIC"RRS-z— -- _ _ __ FORWARD INC LANDFILL Forward shat have no obbpalun to Itce%the wads d Maelhw or Wer ' Forward shad hew no obbpbon to accept the waste d"SOW or OtPW �+ S cordilum upas tlr sale and affec"deposd Of Re waste or d tle waste DISPOSAL METNOIk (TO BE COMPLETED BY FORv+auwl concivro m wpmr ple We and o fecu"deposal d We waste Or a tha waste DISPOSAL METHCiQ: LTO BE COMPLETED BY FORWARD? wtparn the sada 04 alfeciAa eperabon d the LarldFia Forward shad we unpa+rs Ore safe and HI•c>n+dpersum of the LadU Forward shed use _ y t .t ` '3'ti- B70 AERATE StOCxiaE OTHER nesonade drone to promptly svWty Darposar d As haW4 to accep pre ,__. BIOS AF3i E OTHER masmetle afAorts to RonptfY rc*Dr vow OI as nwitly IO a"of 1M i,.. ,..` _ waste far ary reason I Forward s rotusal to accept the waste n tesad on -� '- - worsts fp ary reason tl Forward a telusal>o accept the waste a Oared m SOLI. weatter or otler sae corldwrore.Forward shah notdy the Deposer when ewe ©SOIL weather or dher ode condhons,Forward shad nofdy ft Disposer when sat U*lasts tarbrltpns are a pecled to Manp Wch that Forward mu be able b accept ❑SLUDGE cdndaare ora expecbd to rJsenpe such that Forwani wu be oda to accept _ _ SLUDGE the waste _ _ _ REM4RK5 .. »m 4._ is 3i s• T :�? ❑ • F3EMARKS _ L= -` ^rix ''y1� -s_ NON•FRA&E NOWFRLMU SMS FACMY T1CKE7MIMBER" �_ _ ,<►. ❑ASKUM FACILITY TICKET NUMBER. aa. .a _ .�.s i ❑MSBOD SIGNATU5E AU7}JGR1�Etlr — "r"r DATE'""�'�a ❑YID I _ SIGNA _ _ OFiIZEA'AGE DATE ❑MOD — } --E p �{ ❑ASH �_r` ER THER 1 _ SCHEOULING11IMST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST B&MADE PRIOR TO 4.00 PJA THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULEQf DADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SU JSCHEDULE GAIREFUSAL GOON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL V&DAY BEFORE TO SCHEDULE CALL(200}982-4298 t MANIFEST r 54025 MANIFEST , 5 4 Q 2 R TRANSPORTER COPY