ARCHIVED REPORTS_XR0009801 - Laserfiche WebLink

Home Browse Search

UKWA&) NON-HAZARDOUS WASTE MANIFEST /POKWAKU NONHAZARDOUS WASTE MANIFEST d N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL.FACLLTTY X/ !N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. - JAMES H LANGSTON ❑GLOVES ❑GOGGLESORESPIRATOR ❑HARD HAT t w ❑GLOVES ❑GOGGLES RESPIRATOR QHARDIiAr ._ ❑TYVEK ❑OTHER ( ' ❑TYVEK ❑OTHER �P Q BOX 97 I P,IROX 97 SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES i - -_ PCA 95330 30 _2C9-957-5981 Z0�-957_ J?1. HEriqi„(SQM JP(11tF;IPT �QN ^ _ SIGNATUREfydET►I"f 0 mNATUREb * /,:fes'•%� / � * '�i� � �r, .-�l � RECEIVING FACILM REGFJIMX FICO Ji Y ❑ SLUDGE ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑DISCONOSALSTRUCTION SOL IO ❑ � 9999 SOUTH AUSTIN ROAD Cl DISPOSAL CONSTRUCTION IO ❑ ASH 9999 SOUTH AUSTIN ROAD p CCIIJSTTiLICTION saL ©ASH ❑CONSTRucrloN s011 p asH 0 OTHER ST2C;mIL--- MANTECA,CALIFORNIA 95336 _ MOTHER ST;C,dTI= MANTECA, CALIFORNIA 95336 1 GENERATINGFACd]TY (209)982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE 1' S--"c $T _7qh�^T '�''° 3�TT-? Tr-. �� 40S V T (209)982-1009 FAX _ T s, (209)982-1009 FAX hT-;,)", NAMNAME NOTES TRUCK NUMBER TRUCK NUMBER � � � ;.m1 e�t*LD T�UC.Ir+v Ciu 414t! r �-� 'T ' i, g_-, T71;�rT "�� "� IjLrrf C)'N ADDRESS f+i F'5;LL3 ADDRESS 3^2 0 tUl fE LYE sr t 17 1. 1,1I 0-Ir J,_ CITY STATE ZIP .CITY STATE,ZIP • PHONE ESLD DUMP BOTTOM DUMP TRANSFER PHONE ub DUMP BOTTOM DUMP TRANSFER 0 El 0 13 SIGNATUREuq ORIZED AGENT OR DRNER DATEROLL-OFFS) FLAT-BED VAN DRUMS SIGPdgURE OF AUTHODRIV jJQagD AGENT OR ER DATE t ROLL-OFFIS► FLAT BED VAN DRUMS t I bl S.—T ct 1 ❑ 11❑ ❑ �Y* }-/7 ' L,�!' p ❑ ❑ ❑ FORWARD INC LANDFILL °LB's Y` FORWARD INC LANDFILL CUBIC YARDS Forward Shelf have no obbgat pn to 9=01 the waste d wealhar or other Forward out haw no obtgathon to accept the wast■d weather or other coWd4m impar the sate and elteCawe dh Rx"of the waste or it the waste DISPOSAL i�TyfOD, (TO BE COMPLETED BY FORWARD) condthans mrx aw the sate and ehechwe damsel of rhe waste or d lie wane DISPOSAL METHOD' (TD BE COMPLETED BY FORAARDL te cmmn the sate and eclsre op■rarron of the Landha Forward arhas We DISPOSAL the safe And*Mae"operation of the Landhs Forward shalt use iI5FO5E Bro JAERAIrE SIOCxPaE OTHER reason"■f u 10 010, y r**Ohauoeer of p nawy to=mx the BID AERATE OTHER reasonade efforts to promptly mliy Omposer of as rhatAty to accent me waste far aThr ra"m Y Forward■rekmw m accept the waste is based on waste lor any reason s Forward a reh"to adept the waste is based on weather or other site corhddhohs Forward ansa notiN the Disposer mw a" 0 SOIL weather or other sae condbme.Forward sones rhohty"OW-Poser wbbn■rt ❑SOIL canddKm am expected to Chanpe such that Forward will be able to accept Conadana are eao■cr■d to Charge ach lout Forward wd be able lo accept the waste ❑SLUDGE the waste SLUDGE ~ REMARKS ` REMARKS ASg -1 NON FRIABLE ❑ FACILITY TICKET NUAABER FACILITY TICKET NUMBER ASBESTOS __ r ❑WOOD ©WOOD SIGWSr IrRE OF AUFFi ,AE!!E F"-- DATE SIGNATURT�AUTHOFI ZEPAGENT I DATE ^ ASH _ �_ ❑ASH OTHER SCHEDULIWGAWST-B>:MADE PRIOR TO 4.00 P.M THE DAY PRIOR TO EXPECTED ARRIVAL.ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4 00 P.M THE DAY PRIOR TO EXPECTED 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 WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(2091942-429a MANIFEST• 5 O8 f TO SCHEDULE CALL(209)982 4298 MANIFESTO 54088 GENERATOR COPY GENERATOR COPY