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- ORWARD NON HAZAR S�MNIEST NON-HAZARDOUS MAIEINCORPORATE WkSTE TREATMENT FACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOBACCE"ANCENO, JOB ACCEPTANCE NO. CHH — 4402it Nun l REOIARED PERSONAL PROTECTIVE Et ENT JAMES H L A N G S T011 []GLOVES ❑GOGGLES❑RESPR03R ❑HARD HAT C+ENEFLITOR..a J A M E L w_ « • -. — TY VEK OTHER >IKESN IAP1E5 _h1 LANGdT01! ❑GLOVES ❑GOGGLES❑RESPIRATOR HARD HAT _ ❑ ❑ MA1YdG- SSifi .�L ❑TYVEK ©OTHER P_ 0 BOX 97 C P 0 SOY 9 7 SPE HANDLING PROCEDURES SPECIALwwOLINGPROCEDUREs . LAT4140P CA 95330 • LFTuROP CA 95330 QH0�1E, <--`r 'w,.�'•' s"�} » -r �i 2019-957-5991 2 1 9 -957-542: JAr• COtdG Cf PEF3^aON " L CONTACTPEASOH..�s::s,t�f,+.,,sr�_...�.Ifo_... - _ s JAI] H�EEPPIIiC�KSOV SICNATURE NT 4 aipE ,�-rr RECENNIG FACILITY _ REC EIVNG Fi CKM �. ❑ SLUDGE ❑ SLUDGE © TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑TREATMENT SOIL { NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ DISPOSAL SOIL ❑WOOD 9999 SOUTH AUSTIN ROAD ❑DISPOSAL SOIL ❑WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ❑CONSTRUCTION SOIL ❑ ❑OTHER STOCIDIL MANTECA,CALIFORNIA 95336 ❑OTHER L MANTECA,CALIFORNIA 95336 GENERAT3NGFACLrrY (209) 982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE LA T"''T) "s B4IT ' TaC�,: (209)982-1009 FAX A r TACiLE c ,T= 'T (209)982-1009 FAX C ' NAME NOTES, TRUCK NUMBER NAME NOTES, TRUCK NUMBER RI^r PA11-LTI) T^UC4_ttr, Gr` gr 3E 7 C !LT-., T','Cl ADDRESS ADDRESS 1--, PAULT4E aVc " _ f t' :Q _7 s .CITY STATE ZIP y y ' ( ✓A/vs 1 a .CITY STATE,ZIP r' c - PHONE END DUMP BOTTOM DUMP TRANSFER END DUMP BOTTOM DUMP TRANSFER __' - •_^ PHONE r-5 7 r_L 1 rpt' a ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVERDATE ROLL-OFF(S) FLAT-BED VAI t DRUMS * /v -5 ❑ © ❑ ❑ © ❑ ❑ ❑ ARDS FORWARD INC LANDFILL FORWARD INC LANDFILL `UMG' '� Forward shall hm no cpr,}atwn to accept the waste it weather Or othe, Forward sndt nate M abiYpelran b acoepl IM waste A weather of other corddwm wWwr the safe and effectr4 d151)069t d st fne wave or a are waste DISPOSAL METHOD' 00 BE COMPLETED BY FORVMD1 runtlehOnt prp*the safe and eHedHe dsposat d the waste or W the waste DISPOSAL METHOD' (TO r ssorcan Imre sale and rompuy D dy Dia of the Ids n blyForto Shutt we DISPOSE BIO JAERATEISMCIOU OTHER Yrpars Use sate and eHactna werabon of the Landfill Fpward Stas#use BE COMPI.E5=011 FOOTHR01 waste for NFoes b pr Forty r sr Deal to d ds ra waste b accept Ute rsasorw*NEorls to From*midy Disposer d he vWxlay to acrapl Ina BIO AERATE STOCKPIIP OTHER waste ra of mean It Forward s Forward dl b eecapt the waste u bred rn waste tq •N raasoeh H Forwards refusal b atop!the waste u based on weather a cher We condarorq Forward shaltofwa the 1 be when ode SOIL wasMn ar my site canddw Forward Forward shall coe she DlapOwf when sae Q SOIL l cartlagrtE Sre espectetl b dtMge each that Forward wdl Ce eEre to accept the waste ❑SLUDGE corddem an expected to Chafoa such that Forward wolf be able to accept • the waste ❑SLUDGE REMARKS WN FRIABLE • - - - ❑ASBESTOS REMARKS ❑ASBESTOS FACILITY TICKET NUMBER WOOD FACILITY TICKET NUMBER _ ©WOt]D SIGNATURE- �QRIZED A-#NT DATE ❑ASH SIGNATURE AIFl4 r DATE - -- r - ASH * - - : -�� )C ❑ THEA ER SCHEDULING MUST BE 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 70 EXPECTED ARRIVAL+ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DEUVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUWECT Tb REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(208)982 4298 MANIFEST a S,`i `� 1 TO SCHEDULE CALL(209)082 4298 MANIFEST I 55520 GENERATOR COPY ncucexT�nnav