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I� � � r` � � � LI• LIQ �� ll� i NON-HAZARDOUS WASTE MANIFEST � NONHAZARDOUS WASTE MANIFEST FORWARD FORWARD WASTE TREATMENT AND DISPOSAL FACILITY INCORPORATED WASIE TREATMENT AND DISPOSAL FACILITY !NCORPORATLA JOB ACCEPTANCE NO. CHM— 4402 1 JOB ACCEPTANCE NO. CHN — 4402 GENEWD r . -,,_--==-a,- � _r._ ,, =f-- , - HEQQfMBBW0 u�TECTIVEEanPMENT � GENERATOR fIEo[ PRoTECTIvEEOLMWENT h c _s. LIll�ST�1 y- * ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT I IAL.=S r, LAIRSTONb _ �- ❑GLOVES ❑GOWiLES❑RESPIRATOR ❑HARD HAT �' ° ❑TY-VEK ©OTHER MAILINGADDRESS - 3 i�� ❑TYVEK ❑OTHER P O 811Y,97 _ _ -� }=r�� SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES CITY I EEL Lfi�9-.3A�- LATHROP 'CA 95330 • E Fn T a : - � � it-}Lim ,....�� SAC. .�.^�..T.H. PHONE��Y�- .... - .^ ,,5 209-857-5af: _ CONuka'PERSON M AiLJRE aENr/r D�AsTE SIGhLA1TkiE Et T! OATS/ WASTE ge jr RECEIVING FACILITY RECEIVING FACILITY ❑ SLUDGE ❑SLUDGE FORWARD INC LANDFILL p TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ©NON FRIABLE ASBESTOS ❑DISPOSAL SOIL © viom9999 SOUTH AUSTIN ROAD ' ❑DISPOSAL�L ❑WOOD. 9999 SOUTH AUSTIN ROAD p CONSTRUCTION ML ❑ ASH ❑ CONSTRUCTION SOIL ❑ ASH ❑OTHER --qp '-L= MANTECA,CALIFORNIA 95336 ❑OTHER "- R-' = MANTECA,CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE • GENERATING FACILITY (209)982-4298 PHONE " rT^r Is t'1=T P iA "_ f^ liirr ,7 '1C Lz (209)982-1009 FAX (209)9$2-1009 FAX ;T NAME NOTES TRUCK NUMBER NAME NOTES a �} TRUCK NUMBER qfFTL''�t iPLE,n,I _t'^ ��y�f��- - ' -_Cri �r..ZL{nt TPI"I T� Q ` ADDRESS ADDRESS ,`. - L�4C " ��K` ��c 'Ar r r c I,rc LSA' r a "s8 Pr U,-+€'Z _ CITY STATE ZIP 1 �� I- . CITY SDLTE,ZIP - - :t'r r ' - END DUMP BOTTOM DUMP TRANSFER • PSE- ENO DUMP' BOTTOM DUMP TRANSFER PHONE -57i-tin[ Q ❑ ❑ _u-EE 57[-!11' 0 ❑ _ W44ATLM OF AU H9RIZED/+GENT OR DRIVER DATE ROLL-OFFIS) FIAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGL ENT OR DRIVER DATI_ ROLS) FLAB ❑ ❑ FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL CUBIC YARDS �!� JWea `., Few"shoe Iwro oo oh6pamn to acceoi the waste a weaftr or ohm I Forward c th haw no ohlrpsd t0 45POSBCCgpthe waste d e or 0 V a otter aonp one urpak Cha safe and afte0ft drsposaf of the waste a M IM waste DISPOSAL METHOD' (TO BE COMPLETED BY FORMRD) cord"a uIg the safe and eoper at dept of the waste a A Iha waste DtSpO5A1 METHOD' (TO BE COMPLETED BY TOOTH RD€ etpara dre safe and eflacpw operation of It*Landfill,Forward shoe use reason ata sob and edeaNe aperafpn OI Ma Landuu Fayard apes use DIJ BIO JAEWE OTHER reaaaraala Ofores b mmoth coley Deposer of es!W)kY b aocapt me BID AERATE OTHER reasonable attarts to pft Foch r 8flJY deposer d na rnebrYly b accep the waste Tor any raasaa a Farwart'a relusel b accept the wawa 4 based on waste for arty reason h Forward s refusal to acted the wspo a whenbld"0n mar ar adrr eda cartdaroru Forward trhae rlofrty the Oo-spoam wfrerr weather a dMr see cordarans Forward shalt natdy the Drsposar when arta ❑SOIL CorWerorre are a+pectad b t++mrGa such that Forward will he a0fe b accept r cortwaste are e=pected b chmge such fhat Forward wet De able to actepl the wast SLUDGE dee waste r ❑SLUDGE a a REMARKS ,wJ_ µ _ REMARKS NDN.FRIABLE ❑ NON-FRABLEASSESTO ❑ASBESTOS FACILITY NU _ FNCA_T)Y TICKET NUMBER ❑w000 ❑WOOD y _ SIGNATURE AUTHDRI AGENT [,LATE` Sl�NATUTiE OF AUTHORIZED J)GE � ti DATE ❑ASH // �� y ❑ASH OTHER �C- THER 7!C / ' /� ❑ SCHEDUUNG MUST BE MADE PRIOR)rO E DAY TO ANY UNSCHEDULED LOADS SUBJECT TO REFUSAL UPON ARRIVAL'ONGOING DAILY{DELIVERIES MUST BE SE DAY PRIOR TO CHEDULED WITH THE LANDFILL THE DD ARRNAL ANY UNSCHEDULED AY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAISCHEDULING MUST BE MADE PRIOR TO 4'00 F M LY DELIVERIES MUST BE SCHEDULED WWITH THE LANDFILL THE DAYEFO EE TO SCHEDULE CALL(204)902 4998 MANIFEST# 55504 TD SCHEDULE CALL 1209)982-4208 MANIFEST 0 55505