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tiUKWAKU NON-HAZARDOUS WASTE MANIFEST-- I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY ENT AND DISPOSAL FACUTY F��}j I T/[ n JOB ACCEPTANCE N0. SIM n Vyn�jf NDHAZAR�DOUSWASTE 1ST f INCORPORATED WASTE _ - �y • _ JOB ACCEPTANCE NO. CMk— 4402 3AraE5 M LALJG5TOIt ❑GLOVES []GOGGLES[]RESPIRATOR ❑HAROHAT -- �- ❑TY--VEK ❑OTHER GENERATOR REQtAREDf!ERSONAL PROTECENE EWPMEMr - -P 0 BOX 97 _ SPECIAL HANDLING PROCEDURES IF ES LFf a�rTOF' _ ❑GLOVES ❑GOGGLES❑RESPiRATOR ❑HARpHAT ply - l MAILING ADDRESS _ "ry ❑TY--VEK ©OTHER • LATHROP CA 95330 f ;,1) 5'r pl jpp� CITY STATE,14P Y_ SPECIAL HANDLING PROCEDURES 209-957-5981 • TrP�11`- Cr p�-f -- - PHONE JAN Hw irK">9F ' /fT �► DAAGONU4C7f'E - >-E -Tr•r 5q' SIGNATURE OFHN71VrLE InUE - I w—_ _ _ RECEIVING FACILITY ! © SLUDGE W6STE TYr RECEIVING FAQLIFY ❑ TREATMENT SOIL I ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL DISPO❑ CONS U SOITIO ❑ WOOD 9999 SOUTH AUSTIN ROAD TREATMENT SOIL I ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL p CONsrRurnon SOIL [_j ASH © ❑ I [ OTHER sTOr.oTL_ MANTECA, CALIFORNIA 95336 ❑ DISPOSAL SOIL ❑❑ Ms OD 9999 SOUTH AUSTIN ROAD ❑ CONSTRU'TION SOIL A ` GENERATING FACILITY _ (209)982-4298 PHONE " ❑ OTHER Ltf I ,TL: MANTECA, CALIFORNIA 95336 (209) 982-1009 FAX GENERATING - TF" (209)982-4298 PHONE �" (209)982-1009 FAX NAMF NOTES I TRUCK NUMBER NE I _ Ly TRUCKNADOR'SS -73NOTES UMBER _ i CITY STATE,ZIP ADDRESS t - '-c- 1 Y -' rr��Tei _ "r__, r- c a f' •,' • PHONEEND DUMP BOTTOM DUMP TRANSFER` • CITY STATE ZIP ❑' ❑ ❑ ! " S:GNATLRE OF AUT4OR_ZED AGENT ORDDATE ROLL-OFF{SI FLAT-BED VAN ORJMS PHONE - END DUMP BOTTOM DUMP TRANSFER r� © ❑ ❑ ❑ ❑ ❑ ❑ SIGNATURE OF AUTHORIZED AGFNT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS 13 El FORWARD IINC LANDFILL CUBIC YARDS _ Forward&WI have no oL%Wn to accept"v waste d weather or drier �� CUBIC YARDS conciltrdrta impair�83,e Arid effectne deposal of the waste or d the wast' DISPOSAL METHOD {TO BE COMPLETED BY FORWARD) FORWARD INC LANDFILL arrpaes the sale aril eNectrne operation of the�Z Forward shall use real .efforts to promptfy notify Disposer of Its n exrdy to axebt the POSEi BIO AERATE ISTOCuaAEI OTHER Fns imp shah here no d efie Ion to accept the waste d Heather or Wei III o pairs tr Impair the safe and eopetrre n of the o'the waste or If the waste DISPOSAL METHOD- (TO BE COMPLETED BY FORAI4RD) waale la arty reason u ForH�rds nel�rsa to ecxepl the waste n�d on I IRyBllb tfe safe and eflectrve operation of the Landfd3 Forward shall use waa.w Cr other site Conditions Forward shall rotrty the Disposer when site CII ML— reasona7le efforts to Prartatty notify Drspos:r of Its inability to accept the v DISPOSE BIO AERATE OTHER corddiorn arc expected to charge seer that Forward will be Ade to accept wwie Ice any reason N forwards retrial to accept the waste Is Cased an the Haste 0 SLUDGE Heather or other ase condition Forward anal)rotrf}the Disposerwhen sue REMARKS oordmons are expected to change such that Forward m3 be able to accept Fi NON FRYELE tie waste ❑SLUDGE FACiIJf f TICKET NUMBER ASBESTOS ` REMAR,S _ _ _: NON FRABLE ❑WOOD _ 0 ASBESTM FACILITY TICKET NUMBER SIGNgd'RRE 90tl`fHORIZED AGENT DATE -r1 �'-_ — ❑WOOD f ? ❑ASH 1 SIGNATURE 00 1—aCRMED AW DATE _ LL_;R5- _. 5-45e ��:� ©OTHER ° L /� ❑ASH ❑OTHER SCHEDULING MUST BE MADE PRIOR TO 4 00 PN THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT 70 REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SG1iE0ULE CALL(209)082.4288 SCHEDULING MUST B5 S ARE MANIFEST♦ 555 4 SUBJECT TO REFUSAL UPON ARRIVAL-ONGOING DAILY DE AUVERI S MY PRIOR UST BE SCHEDULED WITH THE D ARRIVAL 9 ANY UNSCHEDULED THE DAYEFORE GENERATOR COFTO SCHEDULE CALL(200)082-4208 MANIFEST I 56'575