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_�-r-��+-.-.:�+� ,r R�.q•� .:r'�''i:�.ra " = RMUS"WASTEMANIFEST- 0 W1` RD: -4 �"=�;�� = ��+ 'NON-1 L4ZARDOUS WASTEMANiFESTr ' = -- `f WASTE TREATMENT AND DISPOSAL FACILITY i'X4 -.1 i, V�STIr TREATWW AND FIJCIL�Y 4 N C-P.W l D R A T E D '# �'� "` J09 ACCEPTANCE N0. - r , ` JOB ACCEPTANCE N0. ©GLOVES ❑GOGGLESQRESPIRATOR ❑HARDHAT JAMES M. LANGSTON ❑GLOVES QGOGGLES❑RESPIRATOR []HARD HAT m All NH IIIIIIIIIIIII01 pTY--VEK []OTHER QTYVEK []OTHER Any 47 SPECIAL HANDLING PROCEDURES P.0 BOR 97 SPECIAL HANDLING PROCEDURES ilign LATHROP CA 95330 • . 209-957-5981 TICKJAN HENRICKSON SIG _ * — * - WASTE T :. " - u► .ea w�y-y-=�1. _ RECEMNG FJ5�3TY"?met Y ��3-=�• � _ Yti45TE TYPE ri 1.<E ,'�3 3r�:S� -.a "7 t ! E1VYdCi FALA[f +s Ott drift s?G ©SLUDGE ❑ SLUDGE ❑ TREATMENT SOI p Nor,-FRIABLE ASBESTOS FORWARDING LANDFILL Q TREATMENT SOIL Q NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ M%POSAL SOIL ❑wOOD 9999 SOUTH AUSTIN ROAD ❑ DISPOSAL SOIL ❑ wow 9999 SOUTH AUSTIN ROAD Q CONSTRUCTION SOIL ❑ ASH ❑ CONSTRUCTION SOL ❑ ASH BOTHER MANTECA, CALIFORNIA 95336 12,koTHER MANTECA,CALIFORNIA 95336 GENERATING FACILITY _ (209)982-4298 PHONE GENERATINGFACJLirY (209)982-4298 PHONE LAdGSTON'S BAIT E TACKLE LA.JGSTO'I'S BAIT TAC,L:- 15515 SEVEOTH ST (209) 982-1009 FAX 35a"15 SEJENT'J ST (209)982-1009 FAX LAT4Rm', CA L1THROP, CA NAME a fie u "�`s. F_ ga :yam +d3ti�- TRUCK NUMBER NAME s,s__��Lj�:�' i� - _ ? u .,i. NOTES _`:�`r` r.r_ TRUCK NUMBER RICH HA4ITLOR TRUCKING _ C�l , �sr/ R PICH HAt1ILION TRUCI.IJJG G t,U ADDRESS - / ADDRESS 1°36 PAULIES AVE LOAD 131 1336 PAULINE AVE LOAD 132 CRY STATE ZIPL !' CITY STATE,ZIP 44DEST0, CA 95350 (/ '13Dc'STO CA 95358 v JJ PHONE END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER 2rJ-573-410t' Q{ ❑ ❑ 2na-573-a10O- �< ❑ ❑ SIGNATURE OF AUTHOR2ED AGENT OR DRIVER DATE ROLL-OFF(S)- FLAT-BED _ VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE _ ROLL-OFF(S) _ - FLAT-BED VAN DRUMS ORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL_ _ CUBIC YARDS F - J I R.ard shalt haw no obfgao0n to=W Me waste N weather or other / l Y Forward shall hne rho oblp bDn to actepL the waste p weather or other f �� cadarons mbar the We and 0ftiNe disposal of the waste or A ax waste DISPOSAL M OD' -(TO BE COMPLETED BX FORWARD) cowitcns W%W tris safe and ettachve dssposal of the waste or A this waste DISPOSAL METHOD' (TO BE COMPLETED BY FORMAD) irnpars the ash and thecbw operation of the t&Will.Forward shall Lee :,µms -Bl0-1��—ETOTHEA wpm the safe and alled"operation of this Landtd Forward"esti __----- - - MasmaEk eNuts to Promptly W*DsPosar of!m inab&ty to*Dow Mlle _ reesonade efkrts to tsurriPltY ratify Drspasu d as rheatgtY m aDcapl ItN SPO �&D AERATE O7i1ER waste b arty reason i FdrwaR s mfiAal to accept Me waste is based m waste For airy reason @ Forward s rclusat Iq nccep the waste rs based weather or Other ars oordarma Forward Map notify the Otsposer when ark IL Heather of other aaa oaderorhs Forward Elias rd1AY the Duoser when 60 _ cord,b.are e:oeGad to dWW such Mat Fdraerd will be able to accent corddrarw ere expeued to Charge such orad Forward will be sate 10&=W a a the wasae y SLUDGE + the waste art T y �_-_ ❑SLUDGE ❑NON4RABLE • r10N•FRIABL£ STOS FACJLRY �''!�"-_^. `fi g©A FACILITY ZIGCETNUMBE�°��"�� WO wow - ,A T AG !'- �..a...i p SIGMA !+ ©WOOD ❑ASH ❑ASH ❑OTHER / {�OTHER SCHEDULING MUST BE MADE PRIOR TO 490 P.M THE DAY PRIOR TO EXPECTED AWYAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST 09 MADE PRIOR TO .M THE DAY PRIOR TO EXPECTED ARRIVAL a 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 MTN THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)982-4298 MANIFEST# 54031 TO SCHEDULE CALL(209)082-4298 MANIFEST i 54032 Te.�av+vwvtarrtw rd.�ee,.w.ee�no+r