ARCHIVED REPORTS_XR0009801 - Laserfiche WebLink

Home Browse Search

••�•• � � �..� w ■wl ww � w w w awe � ■�■r�iw � NON-HAZARDOUS WASTE MANIFEST �1KU NO -HAZARDOU *,4 ,o .� + + C O R P O R A T E D- WASTE TREATMENT AND DISPOSAL.FA6UTY C O R P O R A T E D WPSTE 1REATMENi AND DISPO.RAL FAGq ITY J. JOB ACCEPTANCE N0, JOB ACCEPTANCE NO gum JA!{ES N LANGSTON T ❑GLOVES ❑GOGGLES ElRESPLRA70R ❑HARDHATAN ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARDHAi _ ❑❑TY VEK []OTHER TY VEK [-]OTHER P D BOX 97 P, X 97 SPECIAL HANDLING PROCEDURES LATHROP, CA 95330 SPECIAL HANDLING PROCEDURES LATHRP A 953311 209-957-5981 ?09-57$-4100 �JA I HEN-RICCSOC-�-�..•. - r_ JAY_N�FI•IRIC550N --- s OF P "r-T�DATEw 0'PoZEI�]AGENT/iT[ __ DATE'__ Zv"'7� — VAkm TYPE RECEIVING FACILRY. 1M1IASIE i YPE n ,�=�.=.�s i y__ RECEIVING FACdiTY ❑SLUDGE ❑SLUDGE TREATMENT [I TREATMENT SOL [I NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑DISPOSAL SOIL ❑ w400D [I DISPOSAL SOL ❑ "�°° 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOL p ASH 9999 SOUTH AUSTIN ROAD ❑CONSTRUCTION SOIL E] ASH [ROTHER s+0,k?,IE- MANTECA, CALIFORNIA 95336 (OTHER «? I� MANTECA,CALIFORNIA 95336 • GENERATMFACUTY (209)982-4298 PHONE GENERATINGFACAJTY (209)982-4298 PHONE LL !ST?" ;,=r ' T.C',.= L� � ,>>-?T 7 F-reL= (209)982-1009 FAX _5.15 �_ = r-ti ;T (209)982-1009 FAX l,ni. S_c4_ITS -i LATHROP, C4, 3 L 1HTEW? Ca .r NAME NOTES TRUCK NUMBER NAME ; f NOTES -- r TRUCK NUMBER r arra l%h TLTn-I T=JC"!4C ADDRESS I s `'1 '_3- >4!'t T C13 [ .CRY STATE ZIP CITY STATE ZIP -,SSTI, C1 4r j5c � Vil'✓rS� —cf ILDESi .A �= 8 C- PHONE END DUMP BOTTOM DUMP TRANSFER END DUMP BOTTOM DUMP TRANSFER TO SIGNATURE OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFF(S) FLAT BED VAN DRUMS 13 13 SIGNATU¢E OF AUTHOfO AGENT OR DRIVE DATE11C ROLL-OFFS) FLAT BED VAN DRUMS r '✓� �_� - 7k CUBIC rpm FORWARD INC LANDFILL CUBIC YARDS , FORWARD INC LANDFILL ! Forward snauhaw n00bhgat onwaCced de wastedwealheradher I Forward shwa nave A Oblr1111m to ows ttw waste d weather or other ! j Condnrats unpav the safe and oflectrve disposal of the waste or 4 the waste DISPOSAL METHOD ITO BE COMPLETED,9Y FORWARD) conaaona aroex are safe ane eftecttwe dnoasal dl the waste a S the wash DISPOSAL METHOD- (TO BE COMPLETED BY FORWARD)RD) vrpaea the Sale and effective OWSlion a the LarrdUt Forwud shag use mpaes the safe am eHectne operation Of the Lartlldl Forward shall use gfO AERATE ISTOCOU OTHER reasonable of orts m ommpUY notify Dowser of ds inability to acceDt the DSPOSE BIO AERATE SMCKFLE OTHER reasonable otforts to womGh notify Disposer of ds I WAry to acceot!ne - waste W any.reason If Forward s r#J'"to accoot the wall,is teased on waste Mr aft rtaa0n B Forward a refusal to accept Ing waste rs based on weather a other site condimu Forward shelf r"y the Dispose when site ©SOIL weather Or dew sat canddiorm Forward shall notify the Disposer when site fit- Cdndrucru art t+ptded to charge such that Forward*0 9e able to accept cadddns are expected to cmaro such that Forward mIl be able to accept the waste ❑SLUDGE ute waste Q SLUDGE REMARKS ' REMARKS ❑SASBESTOSNON LE FACLfTY TICxET NUMBER ❑ FACILITY P(:kET NUMBERS , / ❑WOOD p WOOD SIGNATUR&OF A JTHORIZED AGENT 'j` DATE Si m'dbR40F."ORIZEDAGENT/ DATE T _ - ❑ASH r ©ASH THER I�' ! 1 r' /�' "�' ice/ ❑OTHER _ SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO A 00 P M THE DAY PRIOR TO E%PECTED 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 ONGOING DAILY DELIVERIES MUST BE SCHEDULED NTH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209}982 4298 MANIFEST• J eQ�T4 TO SCHEDULE CALL(209)992-4298 -` MANIFEST s 54073 GENERATOR COPY GENERATOR COPY