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NO19-HZARDOUS WAMMANIFEST- NON-HAZARDOUS WASTE MANIFEST E D WASTE TREATMENT AND USPOS&FAcuryFOnYAIM + IA'C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY ; JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. CMM — S 4402 _ - - . GEtRATOR - AEOU7REDpESi90NALPAQiECENEEOli1P1AENi r []GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT -- - ❑GLOVES ❑GOGGLES QRESPIRATOR ❑HARDHAT ❑TYVEK ❑OTHER MAS ( LkitiGST��. _ ❑TY-VEK []OTHER ka. RM i SPECIAL WWDUNGPROCEDURES SPECIAL HANDLING PROCEDURES • TrIROP, ��. y533D -.,. �. r. .- Y �2� -�`a]- CONACTPE1-..9.�- JAN HENAICKS �E�� EIOF//�1UF� D /TITLE DATE * 1 Jti vosm _ �" r 1 t RECEIWW_FACILgY�.?-sir + V4ASTE TYPE RECEIVING FACILITY ❑ SLUDGE CI SLUDGE ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL [] TREATMENT SOUL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑DISPOSAL SOIL ❑vvow • ❑ DISPOSAL SOIL p WOOD C1 CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD El CONSTRUCTION SOIL ❑ASH 9999 SOUTH AUSTIN ROAD IAQTHER MANTECA,CALIFORNIA 95336 • (�OTHER MANTECA,CALIFORNIA 95336 _ .. GENE1t4TINGFACILIYY __ (209)982-429$PHONE GENERATING FACILITY (209)982-4298 PHONE LA IGSTO'1'S BAIT P, TASKL'c _, ,t,-,T,, '� T T L T.,GL- 15:15 SEi,E'ITy ST (209)982-1009 FAX 15 F_tl--f T1 ET (209)982-1009 FAX L4T4R0 CA LLT r r/ NAME :w:_ _-� _ _ _ NOTES- _--_ TRUCK NUMBER NAME , ! , / rTRU—CKNI—MER gSH 431ILTON TRUCIUNG - IL313$'7 ADDRESS" j � ADDRESS p 1336 DAULIBB AVE. _ LOAD 444 5t'`fl,5-i '_IAO =C- CITY STATE ZIP CITY SLITE,ZIP - `109ESTC, CA 95350 T-t 3 VN1oPt�1a CF,SS'!S/ PHONE END DUMP BOTTOM DUMP TRANSFER • PHONE END DLVP BOTTOM DUMP TRANSFER 2n.-579-4100 a ❑ ❑ Ci.s:)(l ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT BED WW DRUMS 51GNATURE OF AUTHORIZED AGENT OR ORIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ FORWARD INC LANDFILL CUBIC VARDS FORWARD INC LANDFILL a»�c YAC L Ferward Shea fuw no dilipaton 10 a..cepl the waste d weather a dtaa Forward Shad hm no obbp Wn lo atxept ltd waste 9 weather a Cher 6-2 cowd*m urpmr an safe aneettectne d+smsal of de wane a a Nt wash DISPOSAL METHOD cowman ages the Sale aw etlaotrve deposal d the t th wads at e waah impays Ihe salt DIM tfe mf ap CI the Lardr,e FCrward shas use {TO 8E COMPLETED BY FORWARD) w rrpaas the ask ami sfte operawn of the Lardhs Forward shW L" ODIIALmETHOD (TO BE COMPLETED BY FORNiARO) reas-OW efforts to PnuMly eddy Disposer Cr ds aubddy W accepttM SPOSE 1310 AERATE OTHER reasmaob elforts to preniptty Way Dos~of da at Wy to aeept the BIO AERATES 0cmf OTHER waste fa DIM nodi.11 Forward a refusal to 6=0Ne waste ori tossed anste IDI vw reason a Forward a refusal to acceptthe waste.based m weaves aother ems cowdsorm Forward SheanDtdy te Disposer whenads LJSOIL weatheror otter am cMldats,Fd &Wward anDlify the Disposer when siteL cendibons ve expected to chmge such Nat Forward.11 Ce abtt to aced oendamrss are expeclae a OwW such Nat Forward wit be able to accept a the wast: ❑SLUDGE Nie waste ❑SLUDGE REMARKS_ REMARKS .t.s_..w-.ol-._....�.. ci NON FFUBLE ASBESTOS FACI[nY/T1E FN�JMBE�R ❑ASBESTOS I FACILITY T]�fKT NUMBEF ;..` .4_ _ ❑WOOQ WOO❑ D SIGNATLJR Ez Y �AG '"`' = DATES„�_ ❑ASH � r ❑OTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 P.M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCKEouu%G MUST BE MADE PRIOR TO 4-004%A 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 ONGOIKG DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)982-4296 MANIFEST,♦ 5 4 0 4 4 TO SCHEDULE CALL.(209)082-4298 MANIFEST r 54043 � TRANSPORTER COPY