ARCHIVED REPORTS_XR0009801 - Laserfiche WebLink

Home Browse Search

�URWAKV NON•HAZARDOUS WASTE MANIFESTFORWARD C O R P O R A T E D V"TE TREATMENT AND DISPOSAL FACIL]TY NON-HAZARDOUS WASTE MANIFEST ' JOB ACCEPTANCE N0. INCORPORATED 4wAsTE TREATMENT AND D4SPOSAL FAcILTTY / JOB ACCEPTANCE NO. JA M LAN6SamN ❑GLOVES ❑GDGGLESQRESPIRATOA pHARE)HAT p� ❑7YVEK ❑OTHER H S T N ❑GLOVES ❑GOGGLES[]RESPIRATOR ❑HARDFW Lti .. P Q $CIX 97^ SPECWLHANDLING PROCEDURES ❑T"VEK []OTHER P 0 BOX 97 SPECIAL HANDLING PROCEDURES LATHROP CR 95110 — 00 �_ _ ATHROp CA 95330 209-957-5981 GOt4r20 209-957-5981 JAN HEN ISK6DN _ _ - --_--- z- SIGNATURE - JAN HEN ICKSON / SIGNATURE AGENT 1.X11- - DATE i • � - * /� 4 _ REGEMNG FAC111TY PIPE RECEIVING FACASTY ❑ SLUDGE Q TREATMENT SOIL p NON FRIABLE ASBESTOS FORWARD INC LANDFILL [] SLUDGE • Q DISPOSAL SOIL D WOOD Q TREATMENT SOIL © NON FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ' 0 DISPOSAL SO'Lgggg SOUTH AUSTIN ROAD � OTHER ='",-,°'`= Iv1ANTECA, CALIFORNIA 95338 ❑ CONSTRUCTION BOIL p �oD GENERATiNGFAC+LET1' r209 982-4298 PHONE ;OTHER ,�'.TO�;�ILE MANTECA, CALIFORNIA 9338 ( 1 • GENERATING FACILITY (209)982-4298 PHONE - -, (209) 982-1009 FAX _44G.TnIp S Sd-T Z T5C(Lc' x,15 8EVL IT" S7 (209)982-1009 FAX .rTAROP, CA NAME NOTES I TRUCY NUMBER r NAME NOTES �1 TRUCK NUMBER i �/ �u`(;.? CA, ADDRESS I r11C4 HA 'T.LTION TPUCr1I: E` _i y _ y J J 4i ADDRFSS 3E °AULIIE AV;-: �OAUi``�S`35 . CITY STATE,ZIP " � -" -=ST _. t f r s`j -CITY STATE IIP PHONE END DUMP BOTTOM DUMP TRANSFER OC:"O, C'S 953 8 ❑ p ❑ PHONE END Of BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED XGE VT DR D R DATE , ROLL-OFFS) FLAT-BED VAN DRUMS �'C� i � ❑ [] 0 0 SIGNAT11TfE OF AUTWRIZED AGENT OR DRNER DATE ROIL-OFFS) FLAT BED VAN DRUMS FORWARD INC LANDFILL cuBlc YARDS CUBIC YARDS FORWARD INC LANDFILL - - - Fpward shall hie M OWgatgn tc accept[he wreste d weather W other cowiliom uttpur the sate am ettectne dwmsal of the vAme or d the wasteDISPOSAL METHOD (T4 BE COMPLETED BY FORWARD) Forward shall rave no oplgaton to accent the waste d weather a other imoays the safe"c leesm coeram-o the Andln Forward shah Ase DISPOSAL rmpai the Bete and effeeme demsal of the waste or d the wasteSAL METHOD (TO BE COMPLETED BY FORV"DI remonade efface to promoty mtd) Draposer of as rtatxltty to aceept the 1 f DISPOSE $t0 AERATE STOC�4.E OTHER ff=n the safe am eNedw operation of the Landfill Forward shell me waste to arty reason If Fawards retwQ1 Ie accept the waste IS based to ressonade er`r+rts rr prom'rt� r*t Disposer of 25 ma7adv to axept the _ _ BIO `ATF(gWa�j OTHEF weather or other are corda,ons Forward shall maty the Deposer when sra ❑SOIL waste to arry lesson N Forward s refusal to accept ter waste s based or ' cor c!44 b are nmected to Charge Such that Fo-wam wife W able to acCapt weather or otrker cAt COrddgns Forward Shall rotrfy Ire Copcser when ars the waste / SLUDGE ccs.ons are expected 10 charge such that Forwafd unit be able to accept REMARKS ` the wast" - M ❑SLUDGE i I W%FRIABLE REMARKS - FACILITY TICKET NUMBER - ❑ASSESIDS - r ❑ASBESTOS��L ❑YID I FRCILIT�11 jKET NUMBER " _ _ ❑WOOD SIGRg0F E O RQED,AGEN' , DATE - SIS�ATU ORI"LE GENT TE ASH H / ❑ASH ✓/ r v'` �� r'`' i�� Q OTHER I 7�C / Ly/ zf'-'- , —, ,Q OTHER I — SCHEDULING MUST BE MADE PRIOWTO 4-01)P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WTTH THE LANDFILL THE DAY BEFORE SCHEDJLING MUST 8E MADE PRIOR 4_W P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE TO SCHEDULE CALL(200)982-4298 56584 SUBJECT TO REFUSAL CALL UPCN 982-4298 ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE MANIFEST I MANIFEST I 56535 GENERATDR CDP nerrcarmn Dour'