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FORWARD KWAKD NON-HAZARDOUS WASTE MANIFEST NON-HAZARDOUS WASTE MANIFEST i" N C O R P O R AVE D WASTE TREATMENT AND DISPOSAL FACILITY INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. Cosh — 4402 + _—.e; - _ r,,,_ t-� GLOVE5 ❑GOGGLES❑RESPIRATOR ❑HARD HAT �R7OR_ _ _ _ __ REQUIRED PERSONAL PROTECTIVE E WIPMENT J A H E SN_H L A G 5 �Nw ❑GLOVES [)GOGGLES ❑HAPDHAT M ❑TYVEK ❑OTHER J�-FS h LAI rcpffNl' u MALING Af]DRESS ❑TYVEK ❑OTHER _P_,__y-.f r ` t rs>:- SPECIAL HANDLNG PROCEDURES D 2111, a i CITY 5�0 PDX 97 _ �yrSmEvZ - SPECU+LHANDLING PROCEDURES . LATHROP, CA 85330 PHONEY 209-957-5981 - JA HENFIUSOh SIGNATURE OF ORIZED 7CI}F OAfE7- SIGENT/TITLE DATE * /i / rr✓� ��D y TYi; -_ - _17- -. - RECEIVINGFACILITY WgTE,WPE —'�'— RECEMNG FACILITY ❑ SLUDGE FORWARD INC LANDFILL ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON FRIABLE ASBESTOS ❑ TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD - ❑ DISPOSAL Solt, 0 WOOD ❑ CONSIRLIL-ION SOIL ❑ ASH ❑ CONSTRUCTION SOIL ASH 9999 SOUTH AUSTIN ROAD ❑OTHER �; c;=._E MANTECA,CALIFORNIA 953,36 _ ❑ OTHER -" MANTECA, CALIFORNIA 95336 GENERATINGFAGILTY (209) 982-4298 PHONE GENERATNGFACILnY (209) X382-4298 PHONE ^s-�" ;� e TA" L= ort -T , (209)982-1009 FAX (209) 982-1009 FAX _,_,,,f,, NAME NOTES TRUCK NUMBER NAME NOTES I TRUCK NUMBER "-J an "iT21, ADDRESS ADDRESS _ !Ec •CITY STATE ZJP .CITY STATE 21P r,T PHONE END DUMP BOTTOM DUMP TRANSFER • PHONE V END DUMP BOTTOM DUMP TRANSFER w-= ;___'r 13 E] E_'j SIGNATURE CF'AUTHORIZED AGENT OR DRP5A� DATE, ROLL-OFF( SI FLAT BED VAN DRUMS SIGNATURE 0F9LiHO'31ZED AGtF CR DRIVER DATE ROLL-OFF(S) rLAT-BED VIA--N� DRUMS .j. ^�, / ❑ ❑ 0 ❑ FORWARD INCLANDFILL CUBIC YARDS FORWARD INC LANDFILL CUBIC YARDS � f Forward shall KrM no obligation to ACCM tte waste d weather or other Forward shall have no oh4yatlon to accept the waste if reacher or Other I �.� Condit*m m,patr the sale and effechrve disposal Of the waste or d the waste DISPOSAL METHOD' (TO BE COMPLETED BY FORWARD) RD) condthons rrpslr the sale and effeotwe tlhsoosal of the wade or N the wastelmpaes the sale aro effectve operation of the Lardrrn For-aro shalt tae I erMn tee Sate and effewwe operation of the ardfdl Forward shall tae DISPOSAL METHOD BE COMPLETED BY FORWARD reasonable etons to MclrhpiM rgi,ty Disposer d ti iNbd,ly ro atxem tw POSE BIO I AERATE^IOCt64E CYTE ER reasonable tHorts to woryxn Miry D,swser of as arability to an-"the _ DISPOSE BIC AERATE�STDDTUI OTHER wase for arw rse-m N Forward s refusal to accept the waste is based on waste for any m&%m N FOrwasd S refusal to b=OM the waste is based On ; weather Or other s-e corderms Forwart st fv*the Dmmer when site weather or ether ane ow-43 Ons Forward shah no ity the Disposer when she ` Olt I cddrt,ans are eapeped to change SUCl1 that Forwera wsN be a»le to aOCept • —6 iorm are ehmec:W o mange such that Forward will be able to accept I the waste ❑SLUDGE w Rhe waste [3 SLUDGE i REMARKS NON-FRIABLE NON FRIABLE�- ? ❑ASBESTOS _ ❑ E i I FACILITY TICKET-NUMBER !� FACILRY T71B .-. �� • ❑YJOOD T qi�F t / / ,❑WOOD I I SIGNATURebF A J;!1IdF TED AGPkT , /DATESIGNA FOR AGEI`f7/ 1 ATE i /i l ❑ H I t OTHER V� ❑ASH !C U(✓"^' / ` / ❑DTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL o ANY UNSCHEDULED LOADS ARE SCHEOULi14G MUST BE MADE PRIOR TO 4-00 PA THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVA.ONGOING DALL'(DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL,ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SChEDULE CALL(209)082-4298 "� MANIFEST• S6 5 81 TO SCHEDULE CALL(209)982-4298 MANIFEST r 57658'0 GENERATOR COPY I I