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k FORWARD NON-HAZARDOUS WASTE MANIFEST * WASTE TREATMENT AND DISPOSAL FACILITY D - T � • JO�A�C, EGEN , INCORPORATED �- �M2 .,•,,,,_.....,...._.,�...._-__. .�c aiOB ACCEPFANCI=N4 ECHM — 4402 • �.. sw;ar ,y.+ .�.'-'m'�w'w r�.ve - £�w" �*.`^'s.'�•,!. ' �- ..� 'LOHHAT GENERATOR ROIREDPERS PERSONAL PROTECTIVE ROTECTIVEEQUIPMENT r iTa �RS ❑GOGGLE$❑RESPIRATOR ❑ HARD HAT❑GLOVE MAL31G ©TY VEK DOTKER SPECIALIMDLINGPROCEDURESr_+ SPECIAL HANDLING PROCEDURES -ft oweti,.-,.r ar.�w--zra.. r�-f +' d'.�K.w+`�i w.V `J' +I ,{,i i_6 Y� CITY Sk�P L.'TP%!OP, ^'TNpOP, C1 i - .�'fiX�n�M1r p a•tt. ;�6T,+"r '> ' r PHONE - -•�r. - IN .l Ali yrjrt p SIGNATURE FiNT/TITLE DATE ��f � • Voxm TYR, RECEIVING FAC9JTY � ❑ sLuocE ❑ TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARDING LANDFILL ❑ SLUDGE ❑DISPOSAL SOIL Q WOQD 0 TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL ASH 9999 SOUTH AUSTIN ROAD • p DISPOSAL SOIL p WOOD ❑coNSTRucnoNsrnL jaOTHER MANTECA,CALIFORNIA 95336 ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD r [OTHER MANTECA,CALIFORNIA 95336 (209)982-4298 PHONE • GENERATING FACILITY (209)982-4298 PHONE LANGSTON'S BAIT & TACKLE 209 982-1009 FAX 15615 SEVENTH ST ( ) - - (209)982-1009 FAX LATHROP, CA - _ - Y NAME NOTES, TRUCK NUMBER 5t P- CL ADDRESS 1,�B_P1�ULISIErA .,_,�_ LOAD 455 ! ! CTFY STATE 23P 3lODESia, CA 95358 _ _;_ o PHONES_- _ ---- �---•-�.—�."s�_- .��T=--- �ENDD- � --- - - =� 1L + S� -�°- WP -'-TPHONE - END DUMP 80TTOM DUMP TRANSFER 209-578-410D z �;- D ❑ ,;a�- ;�-�, �..-x�_ iv SSS CL ❑ ❑ sIGNATURE OFaF1T}+oFjl7fn AZiENTOR ORNER.� OATE -x-,.. Fi4�-0F�FfsS)` Xe-SERI- ?� vAiv oauMs- ---Q El El ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER TE ROLL OFF(S) FLAT BED VAN DRUMS * 8-1�-�S * f y� ❑ ❑ D ❑ FORWARD INC LANDFILL �'' ° —�` ~" �"'— � CUBIC YARDSFORWARD INC LANDFILL Reward sW flare no obbpNbrt t0=401 the waste a weeder or dear Conditions miciar ft 8410 end eflacaw depoml o1 he waste or A Ide waste Forward shah have no odrpatron to aecep Ine waste d wgther a aher } mtays the Nle tend irmanyffecM Deny Dn d the Lits vi Fly to c eA are DISPDSALse imag, IAETEIO ECOMPLE[EDBY'ORV W 01 conditions wrpar the sate and eNectrve disposal 01 the waste a!the waste DISPOSAL MSC (TO BE COMPLETED BY FORMRD) uaiatabk 0tlorta b prdrr Y rtoGy DepGser d rte vy6dty b arced lite rlom"on the llorale ted 4rtrchve aptly Dn of erre Lardb! Fty W 1 Sha!usr -- SPDSE BAD jA9AATEjsTMrj%f OTHER waste for arty mason II Forwards rak"to aeoed the waste a based do waste for effpeS o promptly ready Deposer of pt the waste w arced 1ne wether a dery she conditions.Forward shah mtdy m Deposer when Sar ❑SOL masse IGr any reason q Forward s refusal Id accept the waete a oases On L site Srm cond4tae am eked to change such eller Forward w@ be able to accept weather Or deer fee COnd change a such d Steell Forwa"Ayrd the t be a ser when accept �w�. Celdlwns are etpeClad 10 Char+,a e11Ch[real Fprward wJl Cr able to acttpt ❑SLUDGE t the waste ❑SLUDGE NON fRuBLE 0 REMARKS NON FRABLE Q ASBESTOS ❑ASBESTOS NUMB FACILITY TICKET NUMBER ❑WOOD _ ❑WOOD SIGN61UgfOWAUTHORIZED AGENT--,(�[ DATE e ❑A$N / _ ❑ASH ER 7R _� \ ice_~1, r Lam— [2,07HER SCHEDULING IA PRAOR TTJ PJt1 THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIOR TO EXPECTED ARRIVAL r 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 WMTH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(206)982-4298 MANIFEST* 5405 TO SCHEDULE CALL(208)082-4298 MANIFEST* 54056 - TRANSPORTER COPY- �„ GENERAT[ {QPY_ �. ,