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NON-HAZARDOUS WASTE MANIFEST NON-HAZARDOUS WASTE MANFEST I N C O R P O R A T E D V"TE TREATMENT AND DISPOSAL FACILITY rj C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. , JOB ACCEPTANCE NO. ©GLOVES ❑GOGGLES❑RESPLRA7pR ❑HAADHAT ► ❑GLOVES ❑GOGGLES RESPRATOR ❑TY VEK [:]OTHER ❑TY VEK ❑OTHER ❑HARD HAT P J], BO 47 SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES s • = L T i P CA 95330 A Fz 209_957T534i _293-957E-599� JAlI HE CKSON _ JILu H=NRj;(cDn SIGNATURE _� �� DATE -�'-"� SW%%hTUREOF AGENC%Tl1T__E DATE' 7 RECENINGFACI ITY_,,,,�,is�= c- v_ vosrETYPE - _ __ _�. s- _ _f wa RECEIVMGFACIIr[Y 0 SLUDGE ❑ SLUDGE ❑ TREATMENT SOL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ DISPOSAL SOIL ❑ woo0so9999 SOUTH AUSTIN ROAD ❑pONSTR`L SOIL ❑ 1N H GONSTR9999 SOUTH AUSTIN ROAD ❑ LICTIonL ls piASH ❑CONSTRUCTION soil p ASH OTHER MANTECA,CALIFORNIA 95336 taOTHER 5,rc11,?,Iz MANTECA,CALIFORNIA 95335 GENERATINGFACfLITY (209)982-4298 PHONE GENERATING FACILITY (209)982-4295 PHONE L, 11-STI, I'S . AIT i TAC,L= L" -'-T (209)9$2-1QQ9 FAX 1--+515 St: E ITT ST (209)982-1009 FAX - ZT L�il ar}o LA NAME NOTES ` TRUCK NUMBER NAME + NOTES TRUCK NUMBER _Cit h,+-_T0 . TRLrCs,!G 'rGZI_G ~ T-IlCC- G71 ADDRESS ADDRESS � L !"Ch 4VE _1A7 <i` + - �!V_ CITY STATE ZIP _ CITY STATE,ZIP r - I��fEEY PHONE r r END DUMP r ` ,BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVERDATE ROLL-OFF(S) FLAT BED VAN DRUMS 13 FORWARD INC LANDFILL CUBICY/; FORWARD INC LANDFILL a'MC YARDS <7 Forward shall have nm er o o0lgatnon accapt the wage 4 weathor o torr / Forward ahae love no obapah4 on to accept the waste "mrw or other cCrrd*m arpar the Sale and effect?"deposal of ma waste or 4 ma waste DISPOSAL METHOD 90BE COMPLETED BY FORV"D) cardore impar OW and the he safe d ect?e dMM381 of waste or e pie waste DISPOSAL METHOD, {TO BE COMPLETED BY FORWARD) wrpaw5 on acro and eere~-aperston d Ota Larda�L Forward shalt, nhimsapaws he sale and etlecav"aperaeon at m"Lar" Forward alas use (eafona0le atlorte to wornpuy notdy Deposer d 4e ratably to accept Ila USp=j Bio I AERATE Vj OTHER reasonable ellprts to prwn y-*Deposer d ds rrtatkuy to accept ow NSPOSE BIO AERATE IMI OTHER waste ldr cry?awn 0 Fwwwd■reluoal to accept pte wasp a based on waste for Ary eassoe W Forwards rah"to accept Ow waste a bu ad on warner or ether site corMcm Forward SW notey tM Disposer wtan s4a t weather or otlwr ad"condarorm Forward area r*tnty rho D*oft r wh n ate conato rte are expected to charge Such hat Forward will G atlle io acrsp Condhona are expected to Change such that Forward wa be able to scup 1110 waste 1 ❑SLUDGE the waste ❑SLUDGE • REMARKS REMARKS S WN FF44M _ LE ❑ASBESTUS FXLITY TIP9ET NUy&ER „ FACILITY TICKET NUMBER ❑WOOD ❑WDOD SIGN"OF�1UTHORIZED A9EkT , DATE SIGNAZURE 0� 1713ORIZED AGFrIUTDATEfI V{ i 3 / nr ❑ASH / ❑ASH L •.'�- J V I j ❑OTHER r ( _ r r�r r ❑OTHER / SCHEDULING MUST BE MADE PRIOR TO 4 0".111 THE DAY PRIOR TO EXPECTED ARRIVAL 0 ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL 0 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 WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(208)982 4298 MANIFEST♦ S A 069 TO SCHEDULE CALL{200)992-4298 MANIFEST r S 4 0 70 GENERATOR COPY GENERATOR COPY