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NON-HAZARDOUS WE MANIFEST � WAij7 NON-HAZARDOUS WASTE MANIFESTORWARD jd INCORPORATED WASTE TREATMENT AND DISPOSAL CILITY INCORPORATED VOSTETREATMENT AND DISPOSAL FACILfFY JOB ACCEPTANCE N0. JOB ACCEPTANCE NO. s AFFT A GS QN ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT JAMS M LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARDHAT ❑TYNEK ❑OTHER ❑TYVEK []OTHER • P O BOX 97 SPECIAL HANDLING PROCEDURES * P-0 BOX 97 SPEGLpL HANDLTKi PROCEDURES • _ LATHROP CA 95330 LATHROP CA 95330 rex.'nr.- I 209-957-5981 209-957-5981 JAN HEN CKSON JAN)( H RICKSOfr STCNATURE OF -- 'ice D'p "r SIGNATURE _ E ZiZl * / .a. _ RECEIVING FAamy _ t �i}J. p v:..�a':�- RECEMFJG FACiI RY ❑ TREATMENT SOIL Q NNOON FFRMLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL p NON FRMUE ASBESTOS FORWARD INC LANDFILL • p wow CON�UC ON SOIL [],ASH 9999 SOUTH AUSTIN ROAD p c�oNSTAucra,sal p 9999 SOUTH AUSTIN ROAD i�OTHER MANTECA,CALIFORNIA 95338 POTHER MANTECA,CALIFORNIA 95336 GE14ERATWGFACAITY GENERATING 209 982-4298 PHONE (209) 9$2-4298 PHONE ( I t 175T''lf4r: 9A;T a TAC'L� LA , -ST' rr 0 aalT r TAC,L=_ 209)982-1009 FAX T5515 SKYEJT" ST (209)982-1009 FAX !�-I. ;:Vlr, LArjpfnc, C4 LAT4A0d C4 NAME NOTES r- NAME NOTES. TRUCK NUMBER 'A'ILT+]fI T7UVAG Tq"CKFNG {t"gezjG r '�.h TA IriL,':I T'L CYr(G 9C ADDRESS 5 ADDRESS i' i aAol 1 IE ar: 1 "Au L: :� AE CRY STATE ZIP - .CITY ST?Lf �JP ' " -;Tf, ^A 3.: _ �!'� �rL. 4 IV V3 I�T • ia PHONE END DUMP BOTTOM DUMP TRANSFER PHONE ENO DUMP BOTTOM DUMP TRANSFER nt - 7i� '_' ❑v ❑ ❑ G 11 13 -� t+�n SIGM,Q JM OF AUTHOP)ZED AGENT OR DRIVER JDATE ROLL-OFF � S) FLAT BED VAN DRUMS mn5 ee&�I�I�I/OAIZED AGENT OR DRIVER DATE, ROLL�OFF(S) FLAT BED VAN DRUMS FORWARD INC LANDFILL CUM VA FORWARD INC LANDFILL `�Y'� Forward Shea naw no obhgawn to accsot the rase d wertwr or of w 1 y! Forward dud tore no oblrpataon to accept the waste d weauter or odxr I corWdrora eapew"dam and eaecbw deposal df the wase or d ore waste DISPOSAL METHOD' BE COMPLETED BY FORVtF4RD conoll"m areae the sate and affective dnpoaat of t1m waste or A the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) errpaes to sap rle W acthe operation d Ichap Um Uuxgg Forward use ) mvws the sale W effective operation of the LarWhA Forward arras use nasansde efforts to promptly noWy Disposer of 4s wtxhty to acoeq the 001=1 W I AERATE MI OTHER nuonaW dtorts to 9rprnWy notdy Ouposer d ds wdAty b accept the Disposel 610 AERATE 8ff OV14 OTHER wham For any reasm K Forward'e mhmW to accept ttre wase is based on wane for any reason a Forward s rehraal to accept the wasp a basad on weather or at7rr ate conma n,Forward sltetl IL weather or ober sde car4dorrs Forward OWI nota y the Daposr when a" cawittora are expected to drange uch that Forward wo be able io accept cprWitxxra are expected to cnrrpe aucn tnat Forward wa be oral to uceot Ow" * Cl SLUDGEthBW1SSQ []SLUDGE • REMARKS • REMARKS ASBESTOS ❑NON-FRIABLE FAC MIT6(E7 ER / ❑ FACILITY TICKET NUMBED, -11 ❑ASBESTOS SIGI�b"WAUTHO YiED NT / ❑ D SIGNI�SGRC�OF A�1TfiORiZ�D AG NT J / �y ©ASH �- �+ ✓` L" i z�'f! U rIr OTHER * r I ASH -� ❑OTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 PM�THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4:60 PM THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING HE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(x09)962 429E pALLY DELIVERIES MUST BE SCHEDULED WITH THE LANDFfLL T MANIFEST r 5AG63 TO SCHEDULE CALL(200)982 4296 MANIFEST. 54064 GENERATOR COPY GENERATOR COPY