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j ,FORWAIM NOWHAZAPDOUS WASTE MANIFEST ORWARD NON-HAZARDOUS WASTE MANIFEST INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY INCORPORATED WASTE TREATMENT AND DRSPOSAL FACILITY JOB ACCEPTANCE NO. - #- _ �r JOB ACCEPTANCE NO. ` ~JAMES M LANGSFON ❑GLOVES ©GOGGLES[]RESPIRATOR ❑HARD HAT l JAMES M LANGSTON ❑GLOVES ]--]GOGGLES ❑HAROHA7 ©TY-VEK ❑OTHER ( []TY-VEK ❑OTHER � STATBOX 97 SPECIAL HANDLING PROCEDURES _ P 0 BOX 97 SPECIAL HANDLING PROCEDURES LATHROP_, CA 95330 y . LATHRDP CA 95330 - 205-557-5981 _ 209-95 -5981 COI,TGCTPERSON -_- ^-' �:_ n.. ,-. COK04LT PERSON-" ,r►,_ x.. JAI PENPICKk, JAP HENPICK S0 ' y SIGNATURE OF AUTHORIZED AGENT 7:77TLE DIRTE�"- _ SiGNIC(1JRE o AGENT�_ aK p'_IgE .s r-r WASTE TYPE I w r RECEMNG FACVJU - MZ'TE TYPE _ sea-_ t RECEIVING FACL TY_ „ L7 SLUDGE ❑ SLUDGE I ❑ TREATMENT SOIL p NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL- . !I ❑ DISPOSAL SOIL ] WOOD • p WO DISPOSAL SOIL ❑ OD f ❑ CONSTRJCTIONSOIL p ASH 9999 SOUTH AUSTIN ROAD p CONSTRUCTION SOIL p ASH gggg SOUTH AUSTIN ROAD ❑OTHER ST0rrr0I_E MANTECA, CALIFORNIA 95336 ❑,OTHER STOC,O,Lz MANTECA,CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE GENERATINGFACILTTY (209) 982-4298 PHONE LN l TJ !' T C LE L CT OSJT G- (209)982-1009 FAX 'I T T-1 �L� _ _= T' -ST (209)982-1009 FAX _= J= SE E L-'T ' . L-TdI;a- , ., NAME I NOTES TRUCK NUMBER NAME NOTES TRUCK NUMBER ! jLTnI' 1p, 1,1 ,.',I HA _LTri'I TgLICKIN" � � �� 13 ADDRESS w - ADDRESS J r i 5[� _ 3' rlJt rE� �trc Lr'A' '54 3 PAUL-tl- AVE - .CITY STATE ZIP - - - - CITY STATE ZIP ' r e PHONE _ END DUMP BOTTOM DUMP TRANSFER - PHONE END DUMP BOTTOM DUMP TRANSFER -- _ a © ❑ -_- - © ❑ Cl SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS J 7f 7CIf FORWARD INC LANDFILL custcYA� FORWARD INC LANDFILL cuBICYAFjDyS) Forward mall have no otlgation to accept the waste it weather or other '' Forward ahetF have no otttpatorl t0 accept the waste d Heather or otfter conditions moss the sa r and effective dm=Al of the waste of if the waste DISPOSAL METHOD (TO 8E COMPLETED BY FORYtAR6) conditro s impair the sate and eNectne disposal of the waste or if the wave DISPOSAL METHOD CTO BE COMPLETED BY FOR4160..RUI 'Von opsthe safe art effective operator of the Lardhll Forward shall use ertparrs rite sale apt effacMe dparaser tnrt of the iardfiL Forward Shad use reasaut*e efforts to promptly rorty Disposer of+ m Ls abiity to accept the RXSPOSE & rlE C IAERATEimotfOTFIEp reasonapte efforts to promptly notify D*Do0 Its irtabdity to accept Ina SPOSE B* AERATE 1-� OTI,Fp waste for ant reason a Forward s Iehma to socM the Haste IS based&n I waste for arty reason If Forward s rotusal to accept the waste is based on Heathe or otat her site tdaons Fo-vrard snail notify ft Disposer when site L3 SOIC -01L ' codaiens are expected to&WW such that Forward Halt be able to ac t ++cattier u ct xr see cdridaau Fnrwarti shall nohty the Disposer when site corp bre wage SLUDGE cordams are expected to cftanDe suchw that Forward it to able to accept ❑ ` the waste ❑SLUDGE REMARKS REMARKS NON MMLE FACILITY TICKET NUMBER ❑ASB 5z0.5� ❑ASBESTOS ❑WOOD FACILITY TICKET NUIdBE'�'1 SIGNAYURE OFr4"ORIZEDAENTT �" DATE ❑WOOD SIGNATDRE OF�I)UTHORIZED AGENT _j DATE ASH - - fir - .a r 4 f +� ❑OTHER I + * l� t _h ' + ~ 0 OTHER SCHEDULING MUST BE MADE PRIOR 70 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS APE 60HEGULING MUST BE MADE PRIOR TO 4 OO,P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL,ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE CAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE f TO SCHEDULE CALL(209)982 4298 MANIFEST re 5 5 531 TO SCHEDULE CALL(2091982-4298 WINIFEST• 55532 GENERATOR COPY GENERATOR COPY