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- ----- -- -— - - -- - -- - NON-HZDOUS WASTE MANIFEST' DISPOSAL FACILITY FORWARDWASTE MANIFEST INCORPORATED WASTE TREATMENT AN INCORPORATED WASTE TREATMENT AND DISPOSAL FACILfTY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. CHH — 4402 1 ' GENERATOR _ REOLLOED PERSONAL PA07ECTNE EQUIPMENT J A H E H L A N G S TO N ❑GL S ❑GOGGLES❑RESPIRATOR ❑}iARD HAT jP IEC LIr^c-�� _ []GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT QTYVEIC ❑C7THER MAILING ADDRESS Hwy ❑TYVEK ©OTHER P 0 BOX 97 SPECIAL HANDLING PROCEDURES CITA ��` 07 _ - - - Y - SPECIAL HANDLINGPROGEDURES LATHRDP CA 95390 SZkPHS_ 209-957-5981 GONV=PERSON - JAN HE CKSGPI _ ,n1, HE„ c3= SiGNA7t]RE SIGNATURE OF TOR[ p ITT I TJTLE DATE _ ivigw G FACILffY RECENING FACILITY / - p SLUDGE FORWARD INC LANDFILL ❑ SLUDGE © TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS ©TREATMENT SC4 ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL - ❑ DISPOSAL SOIL ❑ wDDD 9999 SOUTH AUSTIN ROAD p DISPOSAL Sa- ❑ WDOD gggg SOUTH AUSTIN ROAD � CONSTRUCTION SOIL ❑ ASH ❑ CONSTRUCTION SOIL ❑ ASH p OTHER ST9CKC'!L= MANTECA,CALIFORNIA 95336 � ' ❑OTHER "- --- MANTECA, CALIFORNIA 95336 1 • GENERATING FACILITY (209)982-4298 PHONE GENERATING FACILITY (209) 982-4298 PHONE -,-"I^,S711 "S a 15615 SEvc lT•' ST - - (209)982-1009 FAY, _- - - - (209) 982-1009 FAX LATH;CIP, ,; NAME NOTES TRUCK NUMBEF NAME NOTES Z"4}115 € TRUCK NUMBER FR!Cu PAMI L T�N T z.IC'�T_ IS OjjL'P L f� I -L-R - • - i ^ c •ay - ADDRFSS %LAN L..Pq L-F I ✓ ADDRESS - 1330 cAULINE AVE- _17A0 =I- CITY I-CITY STATE ZIP CITY STATE 21Ph - = - All-IDES-10, CA 95�5Lt c U t c PHONE END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFEP -G rL z 110 0 Y ❑ ❑ ❑ ❑ ❑ SIGNAY�E OF ALTTKORIZED AGENT OR DRNEA DATE ROLL-OFF,S) FLAT BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR D_I�VER DATE ROLL-OFF(S) FLAT-BED V4N DRUMS 4!� I� ❑ ❑ ED - ❑ FORWARD INC LANDFILL FORWARD INC LANDFILL Forward YARDS �'�'"YARDS Fprward mall have no ob}gatgn to accept the watte if weather or other Forward shell Imre no obh9atTDr to accept the waste d weather or other tor,tlit*ns rrsse the sate end eNectrrt tlapoas at the waste or A the waste SPOSAL METHOD (TO BE COMPLETED BY FO-"RD) cond4rorm moan aye safe end!((acne disposal of a*waste ur d me wasteimpass the sate and ettectim operation or the Lail Forward shall Lite anaehe tal aE the and-Relm apeaton of the Landfill Forward shall torDSSPOSAL METHOD (TO BE CDMPLETI;D BY FOFIWARD)tore DISPOSAL efforts to to mlMly notify Dispose,of les NWWY to accept the _ V�L DISPOSE� 010 I AERCE O HEP 'easdnabte efforts M Vern--ly notify Lx$D er Of as madlttY to accept the DISPOSE JBID t AERCE IrOMPUl 0--HFR waste Lir awry reasor If Forward s rehAal to*=pt the waste is bated on waste to any roman a Fprwary s refusal to aomot the wade w based on I I� S w�eatne or oche sne oanditC 4 Forward&wi notify vw Dapmer waren aide .� rRather or other Bute cordngns Forward sW mbly,the Disposer when ase ❑SOIL i ) eontl4oru are expected to vww such Cat Forward*0 be able to accept cmdrhwrs am eapectL%J ro charge such that Forward wrs be able to accept === the wgate ❑SLUDGE • the waste _ x]SLUDGE • REMAR}S NON-FRIABLE REMARKS ASBESTOS ' ©FACRITY TICKET NUMBER - - --+ ASB STOS FACILITY T1CYE�p[UMBER f wow ❑WOOD +r�� ___ - SIGNA E ORIZED DATE SKx D AGENT-� ASH _ ©ASH �L I / L ❑OTH -L + �� z��l ❑OTHER SCHEDULING MUST BE MADE PRIpR�4-00 P.M THE DAY PRIOR TO EXPECTED ARRIVAL+ ANY UNSCHEDULED LOADS ARE $CHEOULLNG MUST BE MADE PRIOR TO 4'00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUEJECT TO RECUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY 9FFORE SUBJECT TO REFUSAL UPON ARRNAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE .tv J DAY BEFORE TO SCHEDULE CALL(2991982-4298 56159 3 TO SCHEDULE CALL(299)982-4298 MANIFEST* GENERATOR COPY r