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>� FORWARD NON-HAZARDOUS WASTE MANIFEST ORPORATED WA.S T v TREATMENT AND DISPOSAL FAClLFACILITYNON-HAZARDOUS WASTE MANIFESTfTORWARD C D R P D R A T E p WASTE TREATMENT AND DISPOSAL FACILITY JOS ACCEPTANCE N0. JOB ACCEPTANCE NO. JMES M~ LANGSTOtJ ❑GLOVES OGOGGLESORESPIRATOR ©HARD HATPq ^- QTY-VEK ❑OTHER JAMES F. LANGSTOH ❑GLOVES L)GOGGLES©RESPIRATDR CHARD HAT P 0 eOX 97 _ ❑TY-VEK ❑OTHER SPECIAL HANDLING PROCEDURES P 0 BOX 97 grty SPECIAL HANDLING PROCEDURES SP-9--g—kip- LAROP, CA 95330 - Ri01 �'� LTHROP CA 9539C 209-957-5331 CON-kTPE}tSW—,7 r' �' ="`"' 209_-957-5981 AI; JHEPlAIC�C50W CONVrr~TFEF�SOM�4��=- *' _r _OF SIGNA ^�-R JAs1 HEtIPICKSON TURE AUTHORIZERAG�F,NT% - oVSTE SIGNATUR'OF AUTFfOWED(1GENIT I WASTE / 5 RECENWGFACLLJTY * lisr7�ti/ �Il CJT VASTE TYPE Y_ _ _ _ RECEf"Fi CLrrY_ p TREATMENT SOIL :I ) NON FRIABLE ASBESTOS FORWARD INC LANDT'IL ❑ SLUDGE • ❑ DISPOSAL SOIL ❑ WOOD ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ CONSTRUCTIOn1a0[L p ASH 9999 SOUTH AUSTIN ROAD • ❑ DISPOSAL SOIL ❑WOOD I • p OTHER T�^ °r L. MANTECA, CALIFORNIA 95338 C CONSTRUCTION SOIL p ASH 9999 SOUTH AUSTIN ROAD GENERATINGFACWTY - ❑ OTHER -I�C`�_'-� MANTECA,CALIFORNIA 95336 (209)982-4298 PHONE GENERATING FACILITY TO =;._ (209)982-4298 PHONE 1 sas s_t = TP ^t (209)982-1009 FAX (209)982-1009 FAX rA tNAME NOTES TRUCK NUMBER 11 L 1 3j.' TRL'„\A lI V -. NAME _ NOTES TRUCK NUMBER x`88 s ik"ILTO" „t ADDRESS (I . CfTYSU1TEZIP �I'1- C _)z^ - ?G_ ! ^�- , �T,,_nu A,rc L,-,q,� 2G^ I v T= CITY STATE ZIP - - - -r-/�r X <—G END DUMP BOTTOM DUMP TRANSFER -T r - - _ _ 13 11� ❑ PHONE END DUMP BOTTOM DUMP TRANSF'cP 51GntAt LiHE OF AUTFIt; IZEC AGENT OR ORIVEA DATE ROLL- F(S) FLAT-BED VAN DRUMS ` - ^ E3 12 I , 7` -4 ❑ ❑ ❑ ❑ SIGN � ATU�n7F,qRIZED AGENT ROLL-OFF(S)OR DRIVER DATE r ROLL-OFF(S) FLAT MS BED VAN DRU FORWARD INC LANDFILL CUBIC yA� CUBIC WADS Forward shall hm rw aDhgatlon to accept the wawa d weatt,eer or other �= FORWARD INC LANDFILL , con dais impair the safe and etlectw dlsDosal of the waste or it the waste For ware shall he"no oblgawn to accept the waste d weather or other ,npsss toe safe aro ettectna operation of tote Liur�drw Forward shall use DISPOSAL METHOD (TO BE COMPLETED BY FORWARD; Condit OM impair the sale and e'+ectwe disposal of the waste or d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) reasonable efforts to Pomot+y nohry Disposer of as madJay to accept the DISPOSE 810 AERATE,=CKK LEI OTHER imoal s the safe and effective operation of the LW&H Forward snail use waste for any reason If ForwaMs refusal to accL%n the waste Is bmd On �' I I E teasonadle efforts to promptly notify Dzposer of its Inab,My to accept the POSE Bt0 AERATE 9fOCfffltE OTHER I weather o other 30 ccrWIC-ts r-prwa.d shSA nrtiy the Deposer when site 'J SOIL fff E wastr!or sry res on M FprwarC 5 refusal to accept the waste Is teased on Cddit,ms are a Deetec to charge ash that Fuwwr)wig be able to axe weatner or other vm cor,tl�t�on Fora,n]shall notify the Disposer when ve ❑SOIL ft waste cor,d+twL5 are expecled d un to change slxh that Forward be able to accept • REMARKS SLUDGE the Vaste ❑SLUDGE ❑NON FRLQI.E • REMARKS FACILITY TICKET NUMBER ASBESTOS I ❑NON FRIABLE r ❑WOOD f FACIU7I TICKE�NUMBER ASBESTOS 5IGN!}T{1RE O,F�KiORIZED AG!`NT / DATE [:1WDOD ©ASH I SIGNATURFOF AUTHORIZED AGI`gr ❑OTHER * --- — ?' ❑OTHER I I I SCHEDULING MUST INANE PRIOR TO 4 00 THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE • SUBJECT TO REFUSALL L O UPON ARRIVAL-ONGOING D DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIDR TD EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE h ZO SCHEDULE GALL(209)982-4298 SUBJECT TO RECUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE IM . 55529 TO SCHEDULE CALL(209)962-4296 MANIFESTO 55530 GENERATOR COPY GENERATOR COPY