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NON-HAWDOUS WASTE MMIFEST � FORWARD FORWARD NON-I-IAL4RDous wAsrE MANIFEST Ir INCORPORATED WASTE TREATMENT ME)WPOSAL FACILITY INCORPORATED v pSTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. c ❑GLAVEs ❑GOGGLES❑RESPIRATOR ❑HARD HAT I ❑TYVEK ❑OTHER JA?IESN LANGST N ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT ❑TY-VEX ❑OTHER P 0 80 7 SPECIAL HANDLING PROCEDURES P 0 80Y 97 SPECIALHANDLNGPADCEDURES ' • _T�,RT R � A 95330 ' * air LATHROP CA 95330 209-957E1 209-0579;981 COt+T�M1CT --- JAN HENRIC:SOFI OF �JA ' hEFJRTCKSOtI SKUAATURE 'x SGNATLIREEOl Aga AAaE_72— • WLSTE TYPE - _ ��...yi�:9 = a•�_s, RECEN1tJl LITY a� + -a - WASTE TYPE '_a •-- �.s..,..�_ - RECENWC FAC�JTY -- ❑TREATMENT SOIL ❑ NON GESLUDGEASBESTOS FORWARD INC LANDFILL ElTREATMENT SOIL 1 p ON FRIABLE ASBESTOS FORWARD INC LANDFILL • 0 DISPOSAL SOIL ❑ WOOD ❑ CONSTRUCTION SOIL 9999 SOUTH AUSTIN ROAD ❑ CONSTUSPOSUC-11O ❑ WOOD © �" ❑ CONSTPUC'�IONSOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ OTHER L; a,LF MANTECA, CALIFORNIA 95336 ❑OTHER S=pC'.P_L= MANTECA,CALIFORNIA 95,336 • GENERATING FACIL Y (209) 982-4298 PHONE GENERATINGFACJUTY ;:T ° -T -AC' _an TO (2Q9) 982-4298 PHONE - _5 Z T r- (209)982-1009 FAX - X701, �=ti=- T _- (209) 982-1009 FAX NAME _ NOTES ti TRUCK NUMBERNAME NOTES TRUCK NUMBER ClCr LlA+ LTrJIt T°IJC 2't ADORES, + C 31 3& 1y 9=" �� ISLTOI i P i�I IS f :S= 0AL'LI 15 Ta'S L 5 1 ^- ADDRESS- .CITY SUITE,ZIP ?41 I L T JE A'1 t '71 _ Ir arc - CITY STATE ZIP ,. i � �.�� r lJ J"1 �.�_ " r+- • PHONEEND DUMP BOTTOM DUMP TRANSFER PHONE r , END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRNER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SGNJATURE OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFFIS) FLAT-BED VAN DRUMS 7� ..(�•--M-+ ,c v `bra L-�j ❑ © ❑ ❑ * ' _ V ^r ❑ ❑ ❑ ❑ FORWARD INC LANDFILL I CU22C YARDS r CUBIC YARDS FORWARD INC LANDFILL Forward W+thenavesof not effe t to accept the waste d weather a other ! r �..r condnoru mparr the sere run NIlGtne depOaal of Me waste a d the waste Forward shalt helve no pblx]atgn 10 accept the wane d weather or pillet r moans the safe am elfectrye vara wn c the Lawn Forward snag we DISPOSAL METHOD LTO BE COMPLETED BY FORWARD! conddrpns+ropaa the safe and effectne deposal of the wane or d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORYARM reasorWM eHorts to Pon tY Wrty Deposer of its rrataty to accept the POSEJ MMUI AERATE U OTHER iroam r7 aKs the sale emw operator of his Landfill Forward shall use waste for any reason d F"SM-refusal 10 accept the waste a based on reasonable efforts to Dromptly npGly Disposer Of as mabdrty to accept the / 810 AERATE SIOCICP4E OTHER weather or other are..o-Wh04S.FOrwlu-orlall ifphiy the Deposer when We ❑SOIL waste for any reason H Forward s retuwl m accept the*ante a based on TT-��,, weather or he,,,,e cGYldmz Forward shell nobty the LkSppaer when rule SJ aL catdrapre aro expected to change such Ihat forward rn21 be alga to atteP[ conddons ire e.raected,a change such that Forward wilt be able to accept the waste ❑SLUDGE • _ rte was+n � ©SLUDGE REMARKS NON-FPoABLE • REMARKS FACIVPY'FJ KET NUMBER < � ❑ASBESTOS I FACILM(TJC5E'rAfL�IMBEB ©ASBESMS� - ❑wr000 ❑Y SIGNPPURc'OF AUTHORIZED�_ DATE s _ f� -, ❑ OOD ASH IGNATUREpr AUTHORIZED AGfT D�4TE ❑ H }OTHER r ` ✓ ` /• ❑OTHER ! SCHEDULING MUST BE MADE PRIOR TO 400 PJwS THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUSJECT 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 BEFORE TJ SCHEDULE CALL(209)982-4298 55537 TO SCHEDULE CALL.(209)982-4298 55538 MANIFEST• MANIFEST A GENERATOR COPY GENERATOR COPY