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�■ � ori wfa_ w� �� � ��r nn � � 1VUIY-lI+`ss-wuwuJ tlY/'1a�ILIVY1iVIfLJt R ARD NON-HAZARDOUS WASTE MANIFEST "} '' TREATMENT AND DESPOS&FAcarrY f INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY i" CE N0. JOB ACCEPTANCE N0. �` 4' B ACCEPTAN ♦ y ANES'li LANGSTON ❑GLOVES ❑GOGGLESDRESPIRATOR ❑HARDHAT >ES JAM LRNGSTDN QGLOVES [3GOGGLES❑RESPIRATOR ❑HARDHKr ❑TYVEK ❑OTHER —AOOBOX ❑TYVEK []OTHER P 0 BOX 97 SPECK SPECHANOl1NG PROCEDURES P 0 DX 97 � - _ SPECLALWWDLNGPROCEDURES . LRTHROP, CA 95330 LATHROP CA 95330 + �� a" `�• c�`-�="iw'"'.:�3 209-957-5981 209-957-5981 CQFIAIg PERSOIT7^x HENRICKSON JAII HENRICK504 _AGEKT_�]T[LE y DA of AutHOR�Q AG rlirLEnAm _._' * .� 9;_ 7� r 1 .ZP 9J- VWkSTETYPI; „ __ I =i-_,_L RECENIIN FACrLRY - WASTE TYPE - RECENMFACLIT_Y _ [I SLUDGE p SLUDGE D TREATMENT SOIL p NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOUL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL D DISPOSAL SUL © WOOD 9999 SOUTH AUSTIN ROAD • © DISPOASH coNs uc'no ❑wowH9999 SOUTH AUSTIN ROAD © CONSTRLICTIONSOIL ❑0TH MANTECA,CALIFORNIA 95336 ❑ coNSTRUGTIofasaL ❑ ASH (OTHER g+oak p,1e... EXOTHEA 7'te- MANTECA,CALIFORNIA 95338 GENERATING FACILITY (209)982-4298 PHONE GENERATINGFACRITY (209)982-4298 PHONE Lb GaT]`Ita �3-_7 ' Tar,l= -A 35TriI'S 3AI- . TBCkLE isblc 9EVE,lT-r �T (209) 982-1009 FAX _1.15 - ;T (209)982-1009 FAX 0THC° ''F LAT-4;6' C NAME NOTES 1A TRUCK NUMBER NAME NOTES. TRUCK NUMBER PIC' aA JILTfil T4'-IKCT'l- al4-I HA4ILTnH TRUCKING Cr `zM _ ADDRESS a IJL tf- A. ADDRESS c _s P A r1 L I 'E AVE }v^ y CITY STATE.LP I � . CITY STATE ZIP - - S' 3 4 9 +r r 7:S T"r r' n m_r 0 I V a ] PHONE END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER � - 1---a-R-41 } © ❑ © SIGNATUM OF AUTHOR13F,D AGENT OR DRIVER DATEROLL-OFF(S) FLAT BED VAN DRUMS SIGNATOR£OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(SI FLAT-BED VAN DRUMS * ^ �� 11 ❑ 13 0 E) 11 CUBIC ARDS FORWARD INC LANDFILL CUl�cf ' FORWARD INC LANDFILL Ix Forward artaa have red oblrgahon to accept the waste if we81her of Other Forward ansa have nm opapat*n to accept Otis waste d weather or other 1 ' cortd stuns mpme the sate and eltectwe daoosal of the waste or d the waste ( AS HW (TO BE COMPLFTED BY FORWARD) condi iorm ar"r"safe and emecthv disposal of dw waste a d the watts rrpars the sate and!Nature operahoh d the LAMIA Forward ansa tat rrpaes the safe and eflw.ope h.of dte Landldl Forward shalt use DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) reasonable efforts to promptly nOldy Dnposrr ol ds mabd ty so accept the SPOSE Bl0 JAERATE SlOG�1.E OTHER on reasonable efforts Lo prmptly rmefy Daposer of da nalwy to accept the &O JAERATE:WMIOTHER weath tar arty r smn o Forward a tetras to accept the waste Disposer whenowed" waste for airy ressam M Forwarda refusal Io accept the waste a based mor cond r Or a er pea tOndm her Forward shay nodi r the 1be able when ep weather orother sea ow4bors Forward atop moldy the Deposer when alta SOIL thew sora aro rrMGrd fo charge such Thar Forward wdl tx apse t0 ecCrpt corddax s arc!:paned m champ!act that Forward will W able to accept are waste -SLUDGE the waste ❑SLUDGE REMARKS NON FRUBLE REMARKS ©ASBESTOS NON-FRABLE FACILITY TICKET NUMBER FACILITY TICKET NUM , ❑ASBESTOS'� BER ❑W000 / D /ENT+ ❑WOOD SIC�TURA WAUTHQRIZEO AGENT � DATE SIG.IATU QF 7l•Gt,^, r / � Q ASH ' f ORE DgE k - ❑ASH ! r f`.�c f ❑OTHER * f/ /v/�'!'9 ❑OTHER ` SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 400 PJA THE DAY PRIOR TO EXPECTED ARAIYAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL TWEE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)982-4288 MANIFEST 0 54072 TO SCHEDULE CALL{249)062 4208 MANIFEST 0 54071 GENERATOR COPY GEN OR COPY