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! #mmW W II_ IL v��rr�uW IfVlf'I lrlr�/u l../VLV �Ir•1V r�1a��arr �v. INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY �O jZ T��f WASTE TREATMENT AND DISPOSAL FACILITY T) NON-HAZARDOUS WASTE MANIFEST r� JOB ACCEPTANCE NO + v yrI ITY J IN-CORPORATED ❑GLOVES []GOGGLES[)RESPIRATOR ❑HARD HAT JOB ACCEPTANCE NO. �" — ' " r��_ ._ ❑TY-VEK ❑OTHER GENERATOR -s �+ �, -x '^+ �g—�=------_ DY SPECIAL HANDLING PROCEDURES X7IE _LjLu S,T.IJ� R []GLOVES ©GOGGLES❑RESPIRATOR [)FWPD HAT GCY MAILING ADDRESS�x.„ .-*T ?_.{. - _ ❑TY VEK ❑OTHER — L T r a ::��3 C ° .0 ^DY.r°7— SPECIAL HANDLING PROCEDURES CITY STATE;.Z3P 29 -?j 7- r_Iu38 SCF. 0 s3zr CONL4CT JA a 2n9-OE:-K9n1%iT , SIGNATURE. ENTlTIfLE- DAT' E CONTACTAERSON_ NA - f�AGENT/Z1TLE DATE y SIG TllFIE� / _ / f YPE / I RECEIVING FACILITY ! [] SLUDGE I - WASTE PE 'RECEMNGFACILITY ❑ TREATMENT SOrL ❑NON FRIABLE ASBESTOS FORWARD [NO LANDP7ILL ❑ DISPOSAL SC_ ❑ WoOe 9999 SOUTH AUSTIN ROAD ❑ SLUDGE INC❑ CONSTRUCTIC'SOIL [ ASH ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD C LANDFILL °THE^ _S-OC OIL` MANTECA, CALIFORNIA 9:,336 © DISooSA_SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD D CONSTR'JCTIOW SOI. ❑ ASI- GENERATINGFAC'41T� �209) 982-4298 PHONEp ER MANTECA, CALIFORNIA 95336 - (209) 962-1009 FAX GENERATINC FACILITY (209) 982-4298 RHONE (209) 982-'009 FAX PJAAE i NOTES I TRUCK NUMBER rt-^_ -1 T' T-1 91-1,3 i }:�^J 1 —T- I ,DDRESS - r�" � NAME N=S TRUCK NUMBER �i -C 3 1 3�. CRY STA fT 1'E J Pa -~ t u ,' ADDRESS - r PHONE_ FNDDUMP BOTTOM DUMP TRANSFER CIT"STATE ZIP l v Nc t :c SIGNATURE OF AUTHZRIZEi A3EPF.DRIVER DATE POLL©FFIS) FLAT-EEL VAN DRUMS I -�PHONE----- ' y V V END DUMP BOTTOM DUMP TAANSFFr~ STGN,,TURE Or AJTHORIZED AGENT OR DRIVER DATE ROLL OFF(S) FLAT BED JAN DRUMS FORWARD INC LANDFILL �CURIc YARDS Forward anon "f roOblptgr to acoect thehe ete rt weather or otrf I , _ FORWARD INC LANDFILL CUBIC YARDS cordmvIh Im afee ac s r"am errectrve vsxs.of the waste a a the«este DISPOSAL METHOD (TO BE COMPLEETED BY FORWARDI /'C' anpauS the sate enc:'te^_Irve ocerator C Snt UrOPI Corwaro shall use I r r reasonatlle eftOt, to vurVlq robry L_P:ser Of ILS Ine}Iily to accerl I-e I DISPOSZ� SIC I AERATE isCea i OTHER =orwa� sne I han rip obl�Fatran to accept Ine waste if weather or ot[rr L waste For env reason If Forwards retus.,1 „accept the was a dosed on I-y,�� condi ions rm„;a� the sale Dnp efrec[r.e OesOosal of the waste Or rt the wash DISF'O5l,L,AETHOC I'0 BE COMFLCTE�BY FORWARD) wee tier Or Cther Site Ondrlims Forward Shelf not ly 111e Dwcser when site f..+ u-- rmoarTs the sate and efteChve operatfan c the Landtllr Forward shall use �� iDIEPDSE BID I AERAi E iS10Ct�[l= OTHER conditions are exclecled to Change s tr ra F9rw8rC will"able to acceF I reasonable effort_1C Iaronptn roll) oisooser o aS InaWly to MM the / waste for an, re2S. elm al If Forwards e' al M ACCe9 the waste Is based on the wwle ❑SLUDGE wee he o otrw sr,cond+tr_r1s Fc—aro snas notdy Ire Dmvse when site wOl"- i REMARKS ❑ , I COnOiuon5 er--xl,eoted to change=h tha Forward will be able 10 accept ❑ NCN FRIABLE I! I tie wase S_t1DGE FACILTY TICKET NUMjFER Ass`STDs I REMARKS NON FRM'C ❑SNOODii ❑ASBESTOS I S)GNAUM DF KU'rH0RIZE'J AdENT /DATE I I I I i FACIJTY T'j�AS'FNU;BEF1 _ "I ASH I / /� ❑WOOD * ( r —� S1GNf�TVU�1E OUTHORIZED A/ dT / DATE OTHER It ASH SCHEDULING MUST BE MADE PRIOR TO 4,00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE L OTHER Sl,SJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)982-4298 r` SCHEDULING MUST 8E MADE PRIOR TO 4 OO VM THE DAY PRIOR TO EXPECTED ARRIVAL• ANY UNSCHEDULED LOADS ARE MANIF=_S'_ 5 6 5 FO SUBJECT TO PEFUS..L UPON ARRIVAL ONGOING DAILY DELIVERIES MUST SE SCHEDULED AITH THE LANDFILL THE DAY BEFORE GENERATOR COPY TO SCHFOULE CALL(209)98-4298 MANIFEST* 5 6 561 GENERATOR COPY