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—— � �.� �..�. awri ors � tl� s,# I♦# � # , JR WAS - NON-IfAZAADOUS WASTE MANIFEST r-=�� -f" Y— I N C,o R P O R A T E D " -V#SM TAEATK ENT AM DISPOSAL FACILITY 1 l.!R I rJ NON-HAZARDOUS WASTE MANIFEST f �' JOB ACCEPTANCE N0, INCORPORATED WASTE TREATMENT AND DISPOSAL FACLI TY M , JOB ACCEPT"" N0. JAMES 'k LANGSTON IDGLOVES ❑GOGGLES❑RESPIRATOR ❑HARDHAT IEE GE r ❑TY-VEK ❑OTHER E)GLOVES [jG G�LES❑RESVEA-9OR R ❑�z"m-_A i1 P 0 BOX SPECHDLGPROEDRES MAI� OTHER P O 8X 97 LATHROP CA 95330y SPECIAL HANDLING PROCEDURES � LATHRpP C1t95330 I 209-957-5981 PHONE 209-9576-5981 JAN REMBICKSON ( > JAN HENSZCKSON_- -- `- * SIGGEI- %TITLE- ;'001 _ WASTE 7 E RECENENG FACILITY ❑ SI UDGE ❑TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ SLUDGE I ❑ DISPOSAL SOIL ❑ WOOD ❑ TREATMENT SOIL ❑ NCN FRIABLE ASBESTOS FORWARD INC LANDFILL El CONSTRUCTION SOI'_ 0 ASH 9999 SOUTH AUSTIN ROAD ❑ OTSPOSAL SOIL ❑ WOOD gggg SOUTH AUSTIN ROAD DOTHER ST^CKP_LF MANTECA, CALIFORNIA 95336 ❑ CONSTRUCTION SOIL El ASH • GENERATWGFACIl1TY ❑ OTHER ST-PC '11 ` MANTECA, CALIFORNIA 95336 L.�rGFAL Ia RA:- F 7wCCL= (209)982-4298 PHONE '5=15 5Et15 ITN - GENERATING FACILITY (209) 982-4298 PHONE 15c15P, Cr (209)982-1009 FAX .3` S,i ,�� "!— 9 TAC , -z I IT, s (209)982-1009 FAX NAME i NOTES- TRUCK NUMBER PTCI HSP._LT3 I T;LJCC-1I' Q G� I NAMEy NOTES TRUCK NUMBER I ADDRESS 1C3)3 � r � ^TrJ A --T_ _ /!J4 -,, •036 aAU_T ` �"= ADDRESS; j L� . CITY STATE,ZIP i-^= a s f - F , t L r- IL,=ST3, I -' I V Alb-1'79 • CITY STATE-ZIP `c'HONE END DUMP BJTTOM DUMP TRANSFER _^T^, ,} °r_5 Y ! !-4" © ❑ ❑ ,PHONE END DUMP BOTTOM DUMP TRANSFER GNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFISt FL,'BS.' VAN DRUMS -" _-s [I ❑ ❑ ❑ ❑ ❑ (] SIGNATURE�OF AUTHORIZEDAG6NT OR DRJVE-R-) DATE ROLL-OFF(SI FLAI-EED 44J mw.-- FORWARD INC LANDFILL CUBIC YARDS 1 FORWARD INC LANDFILL CUBIC YARa�s/ i Forward"If new mEa ogtthepn m accept t' waste if weather or Cater condmom rmaaar ft sale and etfrclr a deposal of the waste or a the waste DIS HOD (TO BE COMPLETED BY FORWARD) Forward rials have no ociolicn to accept the waste d weather or other manus the safe And affectle operation c tie Lamm %were rA%U Lye condo ons �Ofi the safe otic PdeCl�we tlaDosal 41 the waste or d the waste reas«tahk efforts to mornotly noUh',Disposer of its rewty to accept me POSE! q0 I AERATE 5tOcf�IL>:I OTHER DISPOSAL METHOD (TO BE COMPLETED BY FORYWPD) waste for sty reason d ForwarC s rami"to accept the waste is Eased on ini ms the waft and effective Operation of the Landfill Forward shall use weather or other Arte corddrdrs Forward.,hall roWy the Deposer wher,site SOIL # frasonaele efforts Ic prDr=* noldy Disposer of ds maErltty to accept the SPOSO BIO AERATE SI 11— OTHER Conimm S are expected to change Such that Forwaro-a be able to accept waste I«any reasOr It Fp ward s refusal to accept the waste rs eased on I me S°'e SLUDGE I weathe or oth-r Site COnddrons Forward shall notify the Disposer when Me 301E i :.aid li«u are expected to chane'each that Forward win be at%e to Accept • PEMARKS I �� the waste ❑ 1" ! i a REMARKS ❑SLUDGF c FACILITY TICKET NUMBER �E�5 ❑AS.BEs v L` t i^ ❑WOOD ! � I FACILITY TICK UNSBER _ SIGNgURE Of'AUTHORIZED AGENT ; DATE _ ❑WOOD I r I ❑ASH I SIGNATURr A�'F ALIf)i6R-ED AGE 1 Df(TE r ',� 1 l t'✓I ❑OTHERI I I * '�` Z^-'17 ASH v G ,i / OTHER t SCHEDULING MUST BE MADE PRIOR TO 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFIL' THE DAY BEFORE SCHEDULING MUST BE MADE PRIOR TO'4-00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHIEDULE6 LOADS ARE TO SCIIEDUI_E CALL 1"111882 4288 56576 SUBJEC-TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE GENERATOR COPY MANIFEST♦ TO SCHEDULE CALL(209)982-4295 _ --- — �,rENI:AATOACOPY MANIFEST! 56577 _