ARCHIVED REPORTS_XR0009801 - Laserfiche WebLink

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� � .�, � ■■�. � � � � IIS � �� �ORWARD 'oRI � NON-HAZARDOUS WASTE MANIFEST NON-HAZARDOUS WASTE MANIFEST L N C O R P O R A T E D WAS TREATMENT AND DISPOSAL FACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. FMK �/ JOB ACCEPTANCE NO. JAMESMM LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT E N ©GLOVES ❑ THER 9❑RESPWATOR ❑HAROHAT AMRNwUACpgE$S`R _ - QTY-VEIL ❑OTHER ❑TYVEK []OTHER P O BOX 97 P O BOX 9 7 SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES �,^- - CfIY LATNROP,�CA 95330 _ _ `�-_ _ �.a.__>w— • CA__LATHROP 95330 PHONE C;-957`599 s� _ � 209-957-5981 OON'OLCTEA PSOIN' . ___1 -r- - J� ' y� JAN N=NAlVKSO`I SKi=OFAUTHOPJZEDAGENCIVRET D1171E. SIG[�L4TLIREOFALnHOF�DJ�f D#E�.� E— • VPS'TE TYPE RECEIVING FACILMY VASTE TYPE I _ -_ _ RECEMNG FACIi17Y ME ❑ SLUDGE fE ❑ TREATMENT SOIL ( Q NON-FRIABLE ASBESTOS FORWARD INC LANDFILL E) TREATMENT SOIL p NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL SOIL ❑WOOD ❑ DISPOSAL.OL. ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL I C ASH 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCT;CNSOIL ❑ ASH ❑ OTHER MANTECA CALIFORNIA 95336 . p OTHER ST^-�-otL- MANTECA,CALIFORNIA 95336 GENERATING CACILFrY GENERATIMSFACILI Y (209)982-4298 PHONE L; l sT _ (209) 982-4298 PHONE A - 3 _- T}:4L=_ =; �=7 ?- T Tr+rL (209) 982-1009 FAX -�rG T;=ti=yT`' 3T (209)982-1009 FAX NAME NOTES TRUCK NUMBER NAME NOTES I TRUCK NUMBER -,' 1`TD' T9Uf KTVG 9�r4 ,l , L Tti1^l= €r ADDRESS - .�I ' C' ADDRESS _ 1p' _� . 7} LI p stir_ 9n- CTf f STFTE 23P - CITY STATE ZIP PHONE FROLL-OFFfS) UMP BOTTOM DUMP TRANSFER • PHONE END DUMP BOTTOM DUMP TRANSFER _,_;77- _J' 1,41 ❑ ❑ SIGNATUR�F17hAL�MORIZED AGENT OR DRIVER DAVE FLAT BED❑ VAN DR�S SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE BULL-OFF(S} FLAT-SED VAN DRUMS J FORWARD INC LANDFILL cuBlc YARDS cuBtG YAMSFORWARD INC LANDFILL ! r' Fpw•ard shalt fare ro,olgaun to a=ep the waste d weather or other - Forward shall here no Obl*3Wn to accept the waste It weather or other eordrt,ons wrpa,r the sale and etfectne disDoeal o'the waste or d the waste DISPOSAL METHOD f70 BE COMPLETED BY FORVi ARD) rnpa, thcoeIde heI sate ano enectwe weeral,onn and effectrye oosat theof ft Lan If FFwor d orwrard the waste shall use DISPOSAL METHOD [TO BE COMPLETED 9Y FORWARD] unpaas the Sate end ehecirve operaiw of the LW109 Forward shall use reasonable•Iforts to oWVS '+tatty Drsposer ct its viability to accept the gSPOSE B'O AERATE ISTO('JCHf OTHER reasonable efforts to promptly notify Disposer of its,nabdny to accept the on 51'O�E SIO AERATE STfJCireaE OTTiEp waste for any reason.H Fo• a-d s refusa to accept the waste is based on c I, weather or,Cher arts ca*ddw'tsblFawarci Ishatlto rodpyt the Ortooser wti'nthe waste is esne ❑SOIL weathe or other arc cortdn,om-orwaro vwu not ry ire Dopose wmen site ©.AIL crrrii6ens tur elr wLc to chance$LCh 1R. Forward Niel 4^obis to accept, cow.:rs are merteo to change suet-trier Forward will be able to accept the waste ©SLUDGE t tt:e waste ❑SLUDGE REMARKS REMARKS NON FRSABLE NON-FPIQLF ❑ASBESTOS FACILITY TICKET NUMBER � ❑ASBESTOS FAGLIT/TICKET NUMBER E)DATE ❑WOOD SIGNATURE IAF AUTHORICF$AGENT i DATE - SI�Wt�JFiEOF AUTHOf}I�ED AsEfl� DATE ASH ❑ASH ❑Or-HER ER SCHEDULING MUST BE MADE PRIOR Y{1 4 OO P MTHE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE-PRIOR TO 4 00 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 THEDAYBEFORE SUBJECT TO E CALL(UPON ARRIVAL ONGOING DAILY DELIVERIES MUS"BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SGHEDU.E CALL(205)582-4286 MANIFEST A 55 SQ 7 TO SCHEDULE CAp1.(209)882-4258 MANIFEST N J J 54 O GENERATOR COPY GENERATOR COPY