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FORWARD NON-HAZARDOUS WASTE MANIFEST FORWARD _ NON-HAZARDOUS WASTE MANIFEST I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY _ d08 ACCEPTANCE N0. cHI4— aaoz r JOB ACCEPTANCE NO. � GENERATOR :. .r°=d_ •. -y-, �:.-.a+. .d�. REaEEDP. CTIVE EQUIPMENT _-4 _ N6STON ❑GLOVES QGOGGLES❑RESPIRATOR []HARD HAT JAMES It LAIIGSTOR ❑GLOVE$ ❑GOGGLES❑RESPIRATOR [I HARD HAT _ DT-V ❑OTHER MQMADORE53 L-� i`E _„_,� >'�sCx�^s t ©TYVEK ❑OTrIER P 0 BOX 97 SPECIAL HANDLING PROCEDURES P o BOX 37 crrswT� SPECIAL HANDLING PROCEDURES CRY,SALTE7JPt; -Cs , 1y t-a--'-� rs • LATHR P C"Ag 533p • LlTHROP _CA 95330 P!i �".tt,.. tf;+_"�.�. :. •.'�''�`'a- '- 209-957-5981 209-957-5961 _ -___ .. �. r• COhIDI 1PERSON -,r -`��-„N1'”- ',�`i�a '1_ _N H E N R I S Q fI _ J A rt N E N P I C!.y 0I SIG E aF ALM)M-? �AJ•WWTff-TRLE�DATE„s.�a SIGMA OF AUTHORED AGENT.TITLE DATE W%STETYPE nJ' C=.�:a; w «� RMENING.FMdITY . VOSTE TYPE RECENNIO FACILITY J ❑ SLUDGE ❑ SLUDGE SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL. � ❑ TREATMENT SOIL NON FRLMBLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT • ❑ DISPOSAL SOIL ❑ WOOD p DISPOSAL TIO ❑ASK 9999 SOUTH AUSTIN ROAD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUcrIONSOL ❑OTH ❑ CONSTRUCTION SOIL MOTHER 5+0�K?rte— MANTECA, CALIFORNIA 95336 OTHER MANTECA,CALIFORNIA 95336 • GENERATING FACILITY (209)982-4298 PHONE GENERATtNGFAGLRY (209)982-4298 PHONE _n:,STfD 'S IT T,C,LE (209)982-1009 FAX LA6` n- c nF3T P Tr^ L* 1-31 Sc'v_rIT41 5T 1_, = 71 FT (209)982-1009 FAX -,Tj-rr, C> _�IrTr� a NAME - NOTE& TRUCK NUMBER NAME ='CH I,Tn ,T,LT�I TPltuf;sltC Tfr�r� dS�9°� TTiU�KNLNNBER ,�-, 402L-21 T=IJCKI IC �'� 31�y r ADDRESS �(LL ADDREss %.� �,t y'. '� ( ?,. ” I L'E Hr- - _ !I'-7 I AVE LEAD 9 77 CITY STATE ZIP .CRY SLATE ZIP I =S T J =' 5,`7 t'`= T , PHONE r « ENDOUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER n 7 _ Z © ❑ ❑ It -;i:-4 1 pU ❑' ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFJS) FLAT BED VAN DRUMS SIGNATURE OF AUTHORIZED AGWT OR DRNER DATE ROLL-OFF(S) _ FLAT-BED VAN DRUMS - �� x`.75 ❑ ❑ ❑ ❑ * ,��[. 3 i4 5 ❑ ❑ ❑ ❑ ARDS FORWARD INC LANDFILL CUBIC YARDS 1 FORWARD INC LANDFILL " Forward 1W have no abepalon to accept the waste d weather w other ther Forward"have no adpaten to accept the waste d weaor other CCn(IAWS wrpaa the sale and efledtwe deposal of the waste Or d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) eongntrare wpm the taro and efkdwa deposal of the waste or If the wage DISPOSAL METHODJTO BE COMPLETED BY FORV ARD) wrpawa the sale and tdwe apovation of the Landfill Forward snag use papaws the rale and efteotwe owshon of the Lirdbk Forwent!Shall tae reasonsM dtorls to promptly notify Disposer ol ds nabdey to storm the WSPOSE BIO AERATE tmca F OTHER neonable aflorta to prompty notify Deposer M as ksbll y to ON Opt the BIO AERATE OTHER waste to,any reason I Forward a ntuaal to accept the wase is based On waste for any meso+.4 Forward a fefleal to accept the watt is bred on weather Or other sea CW4 tons Forward SW notify the Deposer when site ❑SOL wether or other sea coronions Forward shell notify Ina Deposer.weian Ode SOIL conduiens are expected to change such the Forward will ba able to accept cor cuou are expected to denpe such the froward will be able W the waste ❑SLUDGE the waste _ ❑SLUDGE ` REMARKS _ REMARKS _ _tura.11-..e ti-r ti.' ❑NON•fT�ha^c ❑NON _ASBESTOS ASBESTOS FACIL�F TICKET NUMBER r� FACILITY TTC7��T NUMB�F&-ti -_ ❑ ©WOOD 45f�70D S►Gtll+(IU ORIZ ENT _ bATF SIGNATURE OF AUTHORIZELYIIT DATE ❑ 1 _� ❑ASH ASH -' ❑OTPER SCHEDULING MUST BE MADE PRIOR TO¢t00 P AA THE DAY PRIOR T D EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO A OD P M THE DAY pRIOp TO EXPECTED ARgIT•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT U REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL i THE DAY BEFORE TO SCHEDULE CALL(209)982-4298 n TO fiCHEDLE GALL J209J 982 4298 MANIFEST. CA4V 1 OR 7 O MANIFESTS 50477 J -- -- _--_ GENERATOR COPY