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�. �t� IIIIIIIIIIIILi .� ■■■� � � � � � � � � � I� �FORYMAPD NON-HAZARDOUS WASTE MANIFEST — FORVLTARD � NON-HAZARDOUS WASTE MANIFEST INCORPORATED VOSM TREATMENT AND DISPOSAL FACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACMY / JOB ACCEPTANCE NO. / JOB ACCEPTANCE NO. AR AJAMES M LANGSTON ❑GLOVES []GOGGLES©RESPIRATp!R[03 ARD HAT 'JAHES hl+ LAxfGSTOH ❑GLOVES []GOGGLES❑RESPIRATOR HARD HAT ❑TY--VEK ❑OTHER — _]TY ❑OTHER _P D 90X 97 SPECIAL HANDLING PROCEDURES P 0 BOX 57 CC1Y 5DI7E��Pr�- SPEC V+L HANDLING PROCEDURES _ LATHRDP CF 95330 CfiyLATHROF,C M95330 r 209-957-5981 CAI�Fou4'T PERsaN..r �t-..:� - -�.�,��. 2 0 9-�5 7-5 9 3�;•--_ JAN HENRICKSON _ - r` SIGNATURE OF AUJH�D AG=ENT%TITU' _ DATE fa_H P T C K S 0" 1/�ST� ! * rr '4UTFiQR�D' �_..I M w_ Y i ] )t VtE TYPE - _ RECEMNG FA{yLRY VOSTE TYPE -.. RECEMNC FACILITY ❑ SLUDGE © SLUDGE ❑ TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL [3 TREATMENT SOIL ❑ IVON-FRIABLE ASBESTOS FORWARD INC LANDFILL • p CONSTDISPOSRUCTION sort 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION sort Q ASHD ❑ CONST U sol_ E] WOOD 9999 SOUTH AUSTIN ROAD • ❑OTHER SrvC,?-_= MANTECA, CALIFORNIA 95338 ❑ CONSTRUCTION SOIL 0 OTHER T _ _ MANTECA, CALIFORNIA 9533E t GENERATING FACILITY (209) 982-4298 RHONE GENERATINGFACILFTY (209)982-4298 PHONE rc, L_ (209) 982-1009 FAX ;` : t-; ��: = r = (209)982-1009 FAX r I �,�r �-k NAME NOTES TRUCK NUMBER i 1 7 1 i'<1)I I r NAME NOTES TRUCK NUMBER :,T, « '�� L'� =ICS � TL'J Ta1l3X1'lr ADDRESS ADDRESS CITY STATE DP CITY STATE LP ^ PHONE END DUMP BOTTOM DUMP TRANSFER ❑ ❑ IDPHONE END DUMP BOTTOM DUMP TRANSFER -q- ` ❑ ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFFS) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-SED VAN DRUMS FORWARD INC LANDFILL CUBIC Ds CUBIC YID S FORWARD INC LANDFILL r y Forward Shall here no CdVaWn to accept the waste if weather or other / I , condition meat'the sal-and effective dzoosal of the waste or d the waste mare DISPOSAL METHOD, (TO BE COMPLETED BY FORWARD) conditions shalt no obligation to accept the waste d weather or other � I onpaws the sate and e'ledthe operation d the Lardl3l Forward"if use ons rmparr the safe and eftectm dr m56 of the waste art the waste DISPOSALMETHOD' fTo BE COMPLETED BY FOR'WD reasonable r orts to prorrvy notity Disposer of its map&ty to accept the SPOSE SO AERATE St�Cou OTHER unparrs the safe a"d ehectm operation of the LardU Fawrrtl shall the Waste for Ery rF&Sm M forward s refusal to accept Ina waste is!lased on f--- reasonable eMorts to promptly nouly D*Doaer of its rrahalty to accept the RIO AERATE QTF1E� weather or ether we condoxm forward small rotdy the Disposer when ste TSOiL waste for any reset'+ 0 Forwards refusal to accept the waste r5 lased on conditions;are expeCfrJ to change wrh that Forward will be able to accept weathe or other a le conditions Forward shall no the DQ=er when srle r ' the weate ❑SLUDGEcordild ns are expected to change such that Forward will be able to accept ` REMARKS • the waste y ❑SLUDGE ❑NON FRIABLE REMARKS FACIUTY TICKET NIMBER ASBESTOS _ ❑ASBESTFTOS �r A' ©YYOOF FACILITY Tr-KF3:gOMBER ❑WOOD SIG 1�RE `VA ORIZE ENT IDATE SlGfW1TURE/OF AJTKCRI�D AGENT ��' DATE ,y -ti ❑ASH t C1 ASH ❑OTHER 7E []OTHER SCHEDULING MUST BE MADE PRIID"O 4 OD P M THE DAY PRIOR TO EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SCHEDULING MUST SE MADE PRIOR TO 4110 P M THE OAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL,ONGOING DALLY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TD SCHEDULE CALL 1209)982 4299 4 SUSCHEDULEJEOFUUSSALZ ISOs ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE MANIFEST• MANIFEST* 5 554 6 GENERATOR COPY GENERATOR COPY