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�,.. 9-millimun� ll� ff IUlx7Ynju_J r�Vlwf-V�L�tvvvv rif►M11Lnw�u "WI i _ •-- - _ 0 e N C O R P O R A T E D WASTE TREA MENT AND DISPOSAL FACILITY ) FORWARD �p�-}HAZARDOUS WASTE MANIFEST slammommD d08 ACCEPTANCE NO. ✓� INCORPORATED ��T�W�D DISPOSAL FACILITY JOB ACCEPTANCE N0. r C El GLOVES []GOGGLES❑RESPRATOR ❑HARD HAT /�� ❑TY--VEK ❑OTHER P3 9D�X 97 JAMES M LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT SPECIAL HANDLING PROCEDURES MAOINGADdRE >^ ❑TYVEK ❑OTHER PHONEA 3 3 0 CITY SPEGtAL HANDLING PROCEDURES _ M-957-599j LAT"DOP r 533x0 . comc[`PERSCI�FF Y 'yi K 4 y PHONE + ._« -_ -c- J---HE CKSUtt 2C3-9557- 59el - SIG E_L%f[fLE;- pgTE" CONTACT PERSON;,,--�"�"a," ,� �_aJA j - .a 4 1 60I4 SIGNATURE1C6EIITITITLE�` SATE ICSTF E _ _ RECEIVING FAGLL]TY * i �1/�: 1G G ❑ SLUDGE i�TT PE y RECEMNG FACILITY ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL SCI. ❑ WOOD 9999 SOUTH AUSTIN ROAD© CONSTRUCTION SOIL ❑ ASF- ASLUDGE FRIABLE ASBESTOS FORWARD INC LANDFILL G oTHr R =T =' MANTECA,CALIFORNIA 95336 - ❑ Dls>asAL solE C7 WOOD 9999 SOUTH AUSTIN ROAC • ❑ CDN'STnUCTiON SOIL ❑ ASH I GENERATINGFACiLTY (209) 982-4298 PHONE _ p OTHER Gl-� 7i MANTECA, CALIFORNIA 95336 (209) 982-1009 FAX GENERATINGFACUTY (209) 982-4298 PHONE T+- 4T (209) 982-1009 FAX NAME NOTES I TRUCK NUMBER SDDRESS 1/� �✓ �, NAME NOTES TRUCK NUMSE; CITY STATE ZIP � _ I ADDRESS PHONE END DUMP BOTTOM DUMP TRANSFER CITY STATE ZIP -,-,, s v G SIGNATURE OF AUTHOR4'_ED AGENT OR'DRIVER DATE RO!L-OFF(S) FLAT-BED❑ VAN DRUMS PHONE END DUMP BOTTOM DUMP TRANSFER ❑ C ❑ El i} ❑ G SIGNATURE OF AUTHORIZED AGENT OR DRIVER GATE ROLL-OFFISI FLAT BED VAN DRUMS y FORWARD INC LANDFILL CUBIC YARDS * �--^ _ -y!.�, e?0 T{ Forward shall t.ve no obhgstion Iv occeet he wa.te:`weather or other /r'•i FORWARD INC LANDFILL weFe YARDS caid+trons vats the safe and etfec a*ptsbbsal of the waste or a the waste DISPOSAL METHOD {TO BE COMPEL'-TED BY F_ORIVARD] Hro2l" the sale enc eftechve cperaton o'fix I_antl'ill Forward shall use reasonable efforts tc wonrelly not ly iODcae,of its nabraty to accept Ine POSE1 Bd0 AERATE STCCMa' DTHEF Forward shat have no obl+gatm to 8=eM the waste it weather cr other waste for any reason M Forwarc s rctusol to ac=ed the was a is baud or 7 CondnronS l'npalr Me safe and ehectlwe d=sal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORVAfARD) "te f or other st<e Condlixrts Fwweni shall npGty fir Dimmer when site LJ'SO—. IL iffowrs the sate and effectrve operation of the Landfill Fwwarc shall use conditions are er Ine d 4 mange such tsar Forward a be.d•to accent reasonable ehorts to pronofly nobty Deposer d es vralxhty ro accept the �Y DISPOSE BID AERATE SrUdrP[r't OTHER the waste waste for am reaso, If Forward a refuml to acdept the waste�based ort • REMARKS ❑SLUDGE weather or whet silt condilcm Forwarc Shad rolAy the Drsoote when sttt ❑SOIL condnlons are expected to ehanpa such that Forward will be able to accep ❑NON FRIABLEI I I tr. warm ❑SLUDGE FACILITYTICKET )mBER ASBESTOS P}a NON FRuB.E ❑WOOD ASBESTOS SIGNATURE 9�AUTHORIZED AGE1sr t DATE FACILITY TTCfc£T NUMBER _ _ ❑ASH ©WOOD - V I I I SIGVL-UREpF AUTIjIbRIZED AGENT j DATE OTHER _ ❑ASH 4" © I SCHEDULING MUST BE MADE PRIOR TO 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE * { �' - J ❑OTHER SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUS7 BE SCHEDULED V4ITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL t209)982-4288C,�`5'5� SCHEDULING MJST BE MADE PRIOR TO 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL• ANY UNSCHEDULED LOADS ARE MANIFEST+I v V •r SUE.IECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFI-L THE DAY BEFORE GENERATOR COPY TO SCHEDULE CALL(208`082-4298 MANIFEST- 565-S7 GENERATOR COPY