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NON-HAZARDOUS WASTE MANIFEST mbm m m m lNCOR NON-HAZARDOUS WASTE MANIFEST DR3WA"ORA7ED -- WASTE TREATMENT AND DISPOSAL FActurr I N C O R P O R A T E D ATE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. t / JOB ACCEPTANCE NO. r �. � at ❑GLOVES QLE GOGGS©RESPIRATOR ❑HARD HAT H LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR pHARDHAT ❑TY�dEK [)OTHER JAMES ❑TY VEK []OTHER I £.0 _ SPECIAL HANDLING PROCEDURES P OP BOX 97SPECIAL HANDLING PROCEDURES rA 95330 tXTY _LATHROP, CA 95330 209-9457-5991 GaNDIG51 COND4GfPERSON '.• a- � yds 3A11 jJ�� {crm - JAr�HEtd°E SO_N SIGNATURE ENT SIGNATURE _ 1 SITL.E _ DJ1TE. 7k' t✓ j i RECEMNG FACkITY _ WWE _ _;� FtECq"FACILMY ❑SLUDGE ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON FRINKE ASBESTOS FORWARD INC LANDFILL ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ' ❑ DISPOSAL SOIL ❑ " N ROAD ❑CONSTRUCTION SOIL © ASH 9999 SOUTH AUSTIN [j❑ CONSTRucTm SON, ❑ ASH OTHER ,-r ccs. : MANTECA,CALIFORNIA 95336 D%DTHER MANTECA,CALIFORNIA 95336 GENERATNGFACILrfY (209)982-4298 RHONE GENERATINGFAClrY (209)982-4298 PHONE -'r ; _' - -- (209)982-1009 FAX Nf_-r 1' __-r ST ;crier;.. cT (209)982-1009 FAX L 7 Pna ; L'-I R'10 r FMNAME f NOTES TRUCK NUMBER NAME NOTES, TRUCK NUMBER ADDRESS- ' =`!= T-JC"'C -=J s `Lim` TP',C.i'tC gJI4*4 f"_r__ f ADDRESS =i-etc F AV _Y. c •CITY STATE ZIP .CITY STATE ZIP - - END DUMP BOTTOM DUMP TRANSFER r'"-T.. „.c PHONE - • PHONE END DUMP BOTTOM DUMP TRANSFER '^ - -- ❑ ❑ ❑ ^ -- 7 1 ❑ ❑ ❑ SIGNATURE,OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF/I12E ALryW D AGENT OR DRNER DATE ROLL-OFF(S) FLAT BED VAN DRUMS ' ❑ ❑ El 11 r 'ter ' CUBIC YARDS J t a cueIc nom FORWARD INC LANDFILL FORWARD INC LANDFILL Forward"have no ob6gabork to.c«ot the waste a westrw or oth" conddrom rnVw the ante erd eNaalrve d'smul of the waste a d the waste DISPOSAL METHOD {TO BE COMPLETED BY FORWARDI Forward Malliww no obligation to accepi Ou waste A weather or dhar enpa'rs the sale and aNechve operation of the L"ih Forward seas oragi0 AE TE StUCtoRJ< OTHER m cWiam Maar the safe end eflectroe disposal d the waste Of A Ne waste DISPOSAL METHOD, (TO BE COMPLETED BY FORWARD) emonam eilons to pronatty notdy Dsposer d ds rtabddy m arced tri° �'�' amass dee"Ie and ettod"oW&Wn of Ihe LardtA Forward BMA use 8,0 AERATE slocnne OTHER warn for any reason.d Forward's retuml to accapt the waste to Cased m Cl SOL reaswnbM aftu to prOnady no*DOPOW d ds natlhty to accept thatDISPOSEJ waSow or oder sde cd'dArom Forward anal'Wk Dsooser wW sae waste for any reason.b Forward a refusal to sued the wasie a bald pa on drtnm are expected to charge such that Forward w'a be able td accept wealhu or other sde conddrort.Forward ansa mmy the Disposer when sde ❑SOIL the waste ❑SLUDGE cordltlom are e.pectad to d'errQe such prat Forward wig be able m acoep! REMARKS the watts ❑SLUDGErdOH `RIABLE e REMARKS ❑ASBESTOS ❑ ASBESTOS OS FACILITY TICKET NUMBER ❑WOOD FACLrrY TICKET NUMBER ❑WOOD t g URE OF AUTHORIZED AGENT DATE SIGNATURE IORIZED AGENT )I DATE - -- ASH ASK Jt: '% QOTHER * -r \ �bTHER w - 5CHEDUUNCt-mu+T BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO E%PEC7ED ARRIVAL• ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON AR SCHEDULING MUST BE MAD>�r AIDR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE RIVAL,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 LANDFILLTHE DAY BEFORE TO SCHEDULE CALL(208)982 4298 MAfVIFEs7. 54096 TD SCHEDULE CALL 1209)082-4298 MANIFEST, 54095 GENERATOR COPY &FatFRATOR COPY