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OR ARD Noll-HAZARDOUS WASTE MANRST ARD NOWHAZARDOUS WASTE MANIFEST INCORPORATED )HASTE TREATMENT AND DISPOSAL FACILITY �0��"INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. JAMES M LANGSTONDGLOVES ❑GOGGLES❑RESPIRATOR [0]HARD HAT JAMES M LANGSTON ClGLOVES ❑GOGGLES❑RESPIRATOR DHARDHAT P_ 0 60X 97 ❑TYVEK ❑OTHER ❑TYVEK DOTHER _ 7 _ SPECIAL HANDLING PROCEDURES P 0 90OX 97 ' SPECIAL HANDLING PROCEDURES affORIdEffim • _ LATHROP CA 95330 . LATHROP, CA 95330 - 20R-957-5981 a � I N -- 205-557-5..3. II JAN HENRiCYSON NT' ry ,IAT' HEHRIS' 800 I SIGWRt1REL>F.AUTFtGR12Ep�4G � / - W;4STE TYPE w .� _ s,._ _ RECEIVING FACLr Y_ _ _ 1164x^TE TYPE�" -_"y: _fir_ ^.fir•Cfs�'- '+� _ _ _ RECEMNT_FAdL[TY c� ❑ SLUDGE ❑ SLUDGE El TREATMENT SOIL I ❑NON-FRIABLE ASSES70S FORWARD INC LANDFILL [ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL TIO 9999 SOUTH AUSTIN ROAD 9999 SOUTH AUSTIN ROAD ❑ w000 • ❑DISPOSAL SOIL ❑WOOD ❑ CONSTRUCTION SOIL El ASH D OTHER STGJ,c_LF MANTECA, CALIFORNIA 98336 ❑ oO1tsTR�sc oNsolL ASH --t • ryT"'�° MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209)982-4298 PHONE • GENERATING FACILITY (209) 982-4298 PHONE 0 I rSC` L,= T-1 T (209) 982-1009 FAX _- - 'T- ;T (209)982-1009 FAX NAME NOTES TRUCK NUMBER �E - �, - ms's zr NOTES TRUCK NUMBER yT _SII LY ._«'.,,.nr r j ADDRESS A 3 ' ti - tC —� !*7 r�'1 '� �� -C -� ,_LTA J ADDRESS r . _ . v,,li-- CITY ATE Z3P CITY SETE ZIP - t= r cc _ J.-7 PHONE END DUMP BOTTOM DUMP TRANSFER PHONE V J END DUMP BOTTOM DUMP TRANSFER D D ❑ - © 11 11SIGNATURE OF AUTHORIZED AGgNT OR DRIVER DATE c ROLL O(S) FLA©FD A DRUMS SIGN AUTHORIZED AGENT OR DRIVER DATE ROLL ($) FLAT-BEE) A DRUMS FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL CUMCY&Rm Forward shall him nig obligation t0 accept the waste I weather or other Forward Shall here ro odlpaeorr to accept the taste d weather ar Diller J corda,ath erpmrsafe the safe and"Hectic n"of th at the waste a If Ire waste DISPOSAL METHOD' (TO BE COMPLETED By FORWARD) corottlons impar time safe and effective daoosal of the waste ar a the waste DISPOSAL.METHOD (TO BE COMPLETED BY FORWARD) masons the safe and eNecove OPerahan df the Lardllll Forward shall use reasonade etiarts to promptly notmt, Disposer aI its m"ty to accept the DISPOSE 810 AERATE VOWUJ OTHER aesirnpan the safe acrd rornphe notify is of the Lits in Forward shell use reasonable efforts to prongtry notify Disposer of as mebrhiy to accept the USPOSE1 810 AERCEIMOMU OTHER waste for arty resort 1f Forward 5 rwmrd l m eccePt the W111e r hosed on to waste tpf any mayor If Forward S refusal to accept the waste is oma on weather or other sett cond�Stbns Forwafd wall rgtlSy the Dap0.5er when rateIL' weather or otr'er ate condamorrs forward slug maty the Daposer wean ane SOIL COndArael4 ora expected>a Chanpr aurlr mst Forward arta he ode to accept cLZcm are expected to throe sect-that Forward wall be able to Saaapti the was1e ❑SLUDGE the p SLUDGE REMARKS NC+J FRIABLE ` REfAR 55 FRIAIU FAC6LTTY TICKET NUMBER ❑ASBESTps I ❑AARES70S FACILITY.TICKJET NUMBER ❑WOOD ❑WOOD SIGNATURE OF AUTHORIZED AGENT i DATE SIGNATURE�OF f UTHO�iIZEC AG!NT fr DATE x ❑ASH _ ❑ASH ' ©OTHER ❑OTHER - r - , � SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIOR TO EXPECTED ARRIVAL• ANY UNSCHEDLULFD LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 40DPM 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 DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFURE TO SCHEDULE CALL)209)982-4298 Ci h i^ TO SCHEDULE CALL{209)982-4298 MANIFEST* ...l 5 MANIFEST N 55536 GENERATOR Copy GENERATOR COPY