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ORWARV - . - NON-WMDOUS WASM WNFEST F��WARD NON-HAZARDOUS WASTE MANIFEST , I N C V R P O R AT E D � . VWSrEra NT AND DISPOSAL FAC LITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. CMM — 4402 JAMES M LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑KARD HAT MOR REQUIRED PERSOf L PROTEG1WEFOUIPMENT ❑TYNEK ❑OTHER 11AI ES r LAW"-FT-11 ❑GLOVES ❑GOGGLES❑RESPIRATOP [3 HARD HAT f p 0 SOx 97 MMORIESS- _ I❑TY-VEK ❑OTHER SPECIAL HANDLING PROCEDURES MA C�YP r 4-- SPECIAL HANDLING PROCEDURES • LATHROP CA 95330 L.`THR^', s - V _ _ _ 209-957-5981 IAONE _ t� ?' n_c��_nng _ JAM H_E ICKSON CIDN'U4CT PERSON •':�-' �.•_ _ _ SiGL�JATtIRc 11rl Hrl`rrc�"l SIGNA TUR E Oma, d�HO GEN,!TITLE DATE /� ,y� ��.rl.✓l, iG,�i ._.. �_t.. _....,..,w ....,. ,.-.:r;_ RECENT ILAi .! � I • V46M RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL p NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ SLUDGE ❑ DISPOSAL SOIL ❑ wow ❑ TREATMENT SOIL I ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ CONSTRUCTION SOIL p ASH 9999 SOUTH AUSTIN ROAD • ❑ CONST UCriO ❑ASH 9999 SOUTH AUSTIN ROAD ❑ OTHER 'TOC<P;Lt MANTECA, CALIFORNIA 95336 ❑ CONSTRUCTION SOIL ASH � ❑OTHER -` - MANTECA, CALIFORNIA 95336 • GENERATING FACILITY (209) 982-4298 PHONE L4kGSTC1I S 3AIT 3 TACKLE GENERATINGFACJJTY (209) 982-4298 PHONE 25SIE SEkENT)i ST (209)982-1009 FAX _ tG:'__ I L11T,90P, CA _ -. -. `- (209) 982-1009 FAX i _'_z 5 NAME S NOTES ' TRUCK NUMBER NAME NOTES TRUCK NUMBER RICH NAMILTOti T41;CKIiJ; c?t_3 l3S � -,..�. � ADDRESS � G � AADRES.�`': i nr,i�ivi,rVlrhiJG — - 133 PALILI JF AVE L'i = -3D CITY STATE ZIP ,+ - +nnE5T0 Ch 9s^5" IvIve Sir . G1Y th#t ZIPh�t' - PHONE END DUMP BOTTOM DUMP TRANSFER r-573--1nf ,`" r�' "� " ❑ El PHONE- END DUMP BOTTOM DUMP TRANSFER SIGNAt URE OF AUTHORIZED AGENT OR DRIVER DATE"' ROLL-OFF{S} FLAT �-^EKED VAN DRUMS SIGNE.TTSAE bI`AUTHbRSZED AGENT OR DRIVER DATE ROLJ (s) FLAT-EEn VAN DRUMS FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL - C!BIG YARDS Forward shall raw r e obl Baton to accent the writs d vroather or other condn"*,mar thesale and ehectm deposal of the waate or d the waste DISPOSAL METHOD, (TO BE COMPLETED BY FORm%RD1 Forward shalt have-mo oohgalmn to accept the waste d weather or other rmpaes fhe sate ane tfhcave ppefeldrr of the Wrdfin Forward s1Wl use P()SE VO AER0.'fE �� eordArons v7lgmr the:ate arc eitc-Im deposal of the wast?or N the waste remonrhle efforts er to prwnpuy fvity Dmoaof ifs nabrhly to acorn the whom the safe arse-hecto oDeratm d the Lvdlid Forward sha4 use DISPOSAL METHOD (TO BE COMPLETED BY FORNARD) waste for any reason If Forward s rehual to aaepl ft waste a based on ILII reasonable mons to wcrrvFj notdy D6.nparer ot ds marry to accept h,e DISPOSE BJO AERATE-DWILL OTHER weather or other site tcrtd'h�r* Fprwerd shall ncsj y the Deposer when ane �L waste tor any reason if ForwEtl s re%mal to a=pt the waste a towed on Condit*%are expeCtad to charge Such that Forward Neil be able to accept weather ur carr ode oordarons Forward shun notn the Dumer when a" OIL I P*waste ❑SLUDGE cmmals are mrmeaed W tnarw arch t Tat Forwad Wu be Bolo to Scow • REMARKS • the waste _ ED,SLUC,,E ❑Wffil-FRIASUE ASBESTOS REMARKS - NON FRLABLE AGILITY TICKET NUMBER FAOILTTY TICKET"BER - _ ❑ASBESTOS ❑WOOD ' ❑ WOOD I 4IGNATrr'-X4UNORIEC AGENT /,i{,�+�rv+.�c ASH �,�r,,�, _ / ❑ r[ODASH rte —'? sr� I` ?/ OTHER ^- ❑OTHER o S,LHEDUJING MUST BE MADE pR10Tj_70 490 P M THE DAY PRIOR TO EXPECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SCHEDULING MUST 8E MADE PRI SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DEUVL:RIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE ,AR TO 490 P N THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE TO SCHEDULE CALL(209)982 4298 9 SUBJECT TO REFUSAL UPON ARRIVAL OdGOING DAILY DELIVERIES MUST BE SCHEDULED WITH TIRE LANDFILL THE DAY BEFORE MANIFEST,r TO SCHEDULE CALL(209)982-4298 aC 6 578 MANIFEST• GENERATOR COPY