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-- -- J NON-HAZARDOUS WASTE MANIFEST FORyUARD NON-HAZARDOUS WASTE MANIFEST y�"ORWAIW INCORPORATED YVZM " ''�""°D FACILITY !N C a R P 0 R A T E D VOSM TREATMENT AND DISPOSAL FACILdTY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. CMM — 4402 }REOUFEQFER9f�NALPR(71ECfiVEEQUIFMENT ❑GLOMES QGOGGLE5QRE5PEiA10R []HARD HAT GENERATOIR _ �.. _ _ _ ❑TY-VEK ❑OTHER jhl,E° 1, LAI CSTOV ❑GLOVES []GOGGLES[)RESPIRATOR ©HARD HATP Q ©X 97 MALI ADDRESS �` ;-«y OTY--VEK QOTHER _ sPECIALH/WDUhIGFSIOCEDUREs ? O 301 ^7 _ LATHRO9,CA 95 30 crrY SPECIAL HANDLING PROCEDURES F SII �d.: M Y �. rM - PH01NE LATHROR CA.D^3 r' 209-957-5961 _ 20�-95i-59P] JAN HE 1_ CONVM PERSON51GFL[R1REIrr rt-raP;rtW"TURETRLE/ / */ � RECEIVING FAC0.lf Wt P11E RECEIVING FACILITY SLUDGE i E] TREATMENT SOIL [3 NON FRIABLE ASBESTOS FORWARD INC LANDFILL ©SLUDGE ❑DISPOSAL SOIL ❑ VAOOD 9999 SOUTH AUSTIN ROAD Q TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL [] CONSTRUCTION SDIL p AsH DISPOSAL SOIL 0AWOOD 9999 SOUTH AUSTIN ROAD 0 OTHER �T =-� MANTECA, CALIFORNIA 95336 STRUCTION SOIL❑ ' ST =T_ GENERATING FACILITY (209)982-4298 PHONE ❑ OTHER MANTECA,CALIFORNIA 95336 GENERARNGFACg1TY (209)982-4298 PHONE 1�� 5 2EVE ITS•+ sr (209)982-1009 FAX LAI'f-STO c .- r Tf CI L_ L'i lr0=, CA 1c s ^ ;t 5- (209)982-1009 FAX „,OTs TRUCK NUMBER �'T HRilt�, sr NAME SiCN I+a ALTO"I T4i�r :, ( q NAME NOTES, TRUCK NUMBER ADDRESS ..y_ir ISIr "' Tfifr Tr,Ir T ,r• 9_ 17^ti "1'JL-'1E Ar'_ -�N ADDRESS `I` — - .CITY STATE ZIP r !..'r aAV_Tf E rrrc L 11) 1R=3T s . crry SLATE,ZIP + _ PHONE ^' END DUMP BOTTOM DUMP TRANSFER -CLcST[', :'� ,.5r zr, -=' -d I� © ❑ ❑ • PHOS END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFF(S) FLAT-BED YAN DRUMS 20y-5764=1:111 ❑ ❑ ❑ ❑ ❑ ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF($) FLAT BED VAN DRUMSYARDS FORWARD INC LANDFILL d1 BIC FORWARD INC LANDFILL CA's YARDS Forward&Whawno oo�lon to e�0'the waste R wealher Or Oftf ft ur,pw sale and ellectwe dmwW of the wase or a the waste DISPOSAL METHOD (TO BE COMPLETED BY FORYIARD) wpays ft sale and edectree operalron al the Lardee Forward Nall use SPO a10 �� OTHER stra hne w oNVatw,Waccept die waste d weather a ofAer raasaruate dlorts tD promdy n%ly Doposar d ds mtxkty to KUM w txrrdrl”arpar 1M safe ard offect"drs..d the waste or I"wam DISPOSAL METI104c (TO BE WAPLETED BY FORIA ARD) waste for any raason p Forward s felusal Ip accepr the waste Ls Eased on Q��_ ropers the ads and effeebw om%wn d pee LwxM Forward BW use weather or oftr sae cordmoru Forward shah nosily the Daposer when ate faasoneds etlona tD Promgy adlly Dtspwer d Its armlwy to accap tM rSPOSE BIO AERATE OTHER corldll.are expected to charge such that Forward-11 be able to xc wash for any naso I Forward's refusal to apcept ft waste is bated on SOIL • rip waste ❑SLUDGE wea0w or otherde go cor ,ms,Forward shag noWy the Disposer when sheREMARKS condmom are expected b charge mush that Forward w,a be Ab to commNDN FRABLE Ifra wale ❑SLUDGE ©ASBESTOS • REMARKS __ - _r FACILITY TICKET NUMX411-1 WOOD [3NON-FRIABLE ' • FM,I{!TY TICKET NUMBER ASBESTtJ3- S1GI+ ORE QPAUTHORIZED 4ENT r JDATE ©+� ASH SK3kG0.TU F OR � _ DATEASH 0 OTHER h1R SCHEDULING MUST 88 MADE PRIOR 00 TO 4 PM THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE "'�� SUBJECT TO REFUSAL UPON ARRWAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL H5,5513 EF RE SCHEDULINS- IST-BE�"DE PRIOR TO 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE TO SCHEDULE CALL(209)9a2-4296 SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE GENERATOR COPY TO SCHEDULE CALL(209)ase-42911 MANIFEST r 55512 I