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ORWARD 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 t�E TREATMENT AND DISPOSAL FACRLITY �+► _ JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. r ❑GLOVES ❑GOGGLES❑RESPIRATOR []HARD HAT GENE_ ��'-- ES H-LANGS []TY-VEK []OTHER nTYVEK❑GL047E5 ❑❑BOGGLES©RESPIRATOR r]HARD HAT THER P O� BOX 97SPECIAL HANDLING PROCEDURES alY� � CIT9TEJi 9 SPECIAL HANDLING PROCEDURES • LATHROP CA 95390 - 2CS-957-593 2C9-95L5QR' CD>�4EFiS0l1�- JAH HEAIRID- ONY � ,xJr.'I uc'� _CK1-0 r SIGTIATURE - AG _tTI-LE/ ,. GATE SIGNATOR ' J1GEN7/TITLE *� � RECEIVING FACILITY VJ,6TE _ r r.`_ RECEIVING FACILITY p SLUDGE [] SLUDGE ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL 0 TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL • p DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD • p DISPOSAL SOIL ❑ Wool) ©CONSTRUCTION SOIL ❑ ASH D CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ OTHER ��^�''�L= MANTECA,CALIFORNIA 95336 MANTECA,CALIFORNIA 95336 � ❑ OTHER '�-��r__ GENERATING FACKIry (209)982-4298 PHONE • GENERATING FACILITY (209)982-4298 PHONE 3 "�'' �'" (209)982-1009 FAX - -- ;:,T4 S; , , , ' ' `', .'- - - (209)982-1009 FAX :' ,T I- A 7 c- x NOTES, TRUCK NUMBER NOTES�I 1r TRUCK NUMBER NAME tT,t v-s, 9c3i3ft� _ NAME {�IC' Kd,I_ i i 77tI� �C �, -T^ -1-1 TILT i' T7ll� =u, ''' �'•- �C ADDRESS 9 vtra ADDRESS CITY STATE.ZIP I ✓/)/C � cr CITY STATE ZIP • PFIONE END DUMP BOTTOM DUMP TRANSFER END DUMP BOTTOM DUMP TRANSFER © 11 PHONE C3 13 0 SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-W(S) FLAT❑BED O DRQ SIGNATuRYOF AUTHORI7�$AGENT OR ORNER DATE ROLL-OFF(S) FLAT BED' VAN DRUMS 13 0 FORWARD INC LANDFILL FORWARD CUBIC YAWS - ' FORWARD INC LANDFILL Forward eha9 have no dwpaba,b eaceyl the waste if weather or other Cprtditxxu wnpar the safe and etfecbre d4POaal d the waste or e are waste DISPOSAL.METHOD' (TO BE COMPLETED BY FORV"D► �^w�wth haK no 4 en&d to accept the wade d e or A r e este i wg%m"safe aro Nfecbve omabon d the Landhil Forward shah use w"ir ans sale the safe,* etlectrre n of the d the waste w 1 the wastt 'DISPOSAL.M�FFf {TO BE COMPLETED BY FOOTHER 1 reasonable efforts b pror»otty oahfy DMOeer d as Msb"y to accent the Bl0 AERATE OTHER nnpeva tlw safe ar,d aHedna al>Heftorn d the L�ndtra Forward slue use ' 00 AER gtpprPeE DIFFER waste lor any reason b Forward's retinal 1D accW the waste 4 based on ressonaW eltarp to pontd�notrfy A6DDaar A as etahrfwY b accept tlM weather w dew We aantlrfrons.Forward shalt nobly One DOPOaer when ate L waste Id any rens-n tl ForwArd a retinal as uceM the waste a CesAd on IL conao-d we eapSCW to doge Such ttwt Forward wA be able to accept weattw w dr,er ate conddpna Forward sties rs7lrfy the Disposer when see me waste ❑SLUDGE Icor waste are expected b d drpa s rJr That Fowe d ora be ACM to ecaad o SLUDGE REMARKS NON-FA4h8LE ` REMARKS NON FRIABLE ❑ASBESTOS ❑ASBESTOS FACILITY TICKET NUMBER [3 YAM FACiLTTY 1) KET NUMBER � ❑WOOD SIGNATUREAFfgqiORIZE�ENIT / DATE ©ASH SIGNATURE PF AUTHORIZEDAENT DATE ' J [3 ASH *^ ✓ n fa -f ``" r Y %'," ❑OTHER '1C !" t lti�� /V"! OTHER SCHEDULING MUST BE MADE PRIOR TO 4-00 PJA THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARESCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRiDR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFI}SALUPON 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(2D9)982 4298 MANIFEST. 54097 TO SCHEDULE CALL(200}!+82-4298 MANIFEST♦ 54 0 9 U GENERATOR COPY