ARCHIVED REPORTS_XR0009801 - Laserfiche WebLink

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�RWA�tD NON-HAZARDOUS WASTE MANIFEST /FO,RWAP.D NON-HAZARDOUS WASTE MMIFEST INCORPORATED VOSM TREATMENT AND DISPOSAL FACILITY I N C O R P O R A T E D VMSTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. JAMES M LANGST011 ❑DANES []GOGGLES[)RESPIRATOR ❑HARD HAT M ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT []TYVEK []OTHER CITY-VEK []OTHER P D E 0 X 97 SPECIAL HANDLING PROCEDURES Iy -�- SPECIAL HANDLING PROCEDURES • _LATHROP CA 95330 • �` N ° � 209-957-5981 209-457_-5 COFIV4GT. ,�:s CONTP�PfR50N�__ JAIL HEt rCk50 JAI �H- rso, — _ - -- -- -- - SIGNATURE /' mff DATE SIGiW EIN AGT 7E _ x �' / RECEIVING FACILITY _ -- RECEMNGFACILrTY - • ! ] SLUDGE h I ❑ SLUDGE [3 TREATMENT SOIL � ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL E) TREATMENT SOIL ❑NON-FRIABLE ASBESTOS FORWARD INC LANDFILL � • ❑ DISPOSAL SOIL J WOOD • ❑ DISPOSAL SOIL ❑WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION solL ❑ ASH 9999 SOUTH AUSTIN ROAD p CONSTRUCTION SOI p ASH ❑ OTHER �TnC{PTL_ MANTECA, CALIFORNIA 95336 . E[OTHER MANTECA, CALIFORNIA 95336 • GENERATING FACILITY (209)982-4298 PHONE GENERATING FACILITY (209) 982-4298 PHONE (209) 982-1009 FAX (209) 982-1009 FAX NAME I NOTES TRUCK NUMBER NAME NOTES _ # TRUCK NUMBER ADDRESS _ ADDRESS . CsTY STATE ZIP CITY STATE ZIP y PHONE END DUMP BOTTOM DUMP TRANSFER PHONE- END DUMP BOTTOM DUMP TRANSFER - . ❑ ❑ ❑ SIGNATURE OF_.DTRORIZE�ENT OR DR1VEA DATE RO-OFFISI FLAT BED VAN DRUMS SIGNATURE OF ALTHORIZEL AGENT CP DINER DATE ROLL-OFFS) FLAT-BED VAN DRUMS ❑ ❑ © ❑ J FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL CUBIC YARDS Forward otic!!here wobgahon to accent the waste rt wea-her a other � �T Forward Shell hvye no ohdgatian to aCCW the w2M d weather rx Other (� cards! er pair the sate arts eftwrve tlrposal of the caster r the waste DISPOSAL METHOD {TO BE COMPLETED BY FORWARD]the 1!°pa'r the sale and effective disposal of the wage m d the Name DISPOSAL METHOD' {TO BE COMPLETED BY FORV�Y4RDI mrpa,rs the safe aria eow;lroe 00"tioi or the LarW W Forward shall use grtpaes the safe end ettectrve operatian of the Landfd! Forward shall use Ir�rSPOSE BSO AERATE 3MCOU OTHER masombie etforts to erdnViv nobly L4scose M rL .tabdny to accent me DISPOSE BID AERATE{STOMPLE OTHER masonade efforts to P rcmpthy nmfy Deposer of rts nubility to accent the II", waste for erry reason Y r-orwa-d s m=a 'o adcaot the wawa is based on I i waste for Sri,reascn 11 Pww3rd s re`usal to accept the wl to is hosed on ❑SOIc he t weather Or oirxf arts Cpndrlor'S FerNdrj St1ah rotdy Ilte DepOSEr w4tsn site conditions or other see cerrde-cm}crward shell nonty the Deposer when site condrt�are exDecred lu charge suco t--at Fa-ard wilt b�able to&neap he wast, are eanectaC to rlttirpe soh Incl Forward wiB be able!o accept the waste ❑SLUDGE tARKtitARK ❑SLUDGE • RENUiRKS ! • RCC NON FRIABLE NON FRIABLE I ❑ FACILITY TICKFT,�WMBE�- ` ❑ASBESTOS FACILITY TICKET�I UhPER``t ❑ASBESTOS ©WOOD � SIGNA,T(JO�yAl—qRE 'ORIZED'AGEIGT D/AE $GINAT] 0F,41TiORIZF AGENT DATE - i r ✓ ❑ASH y , / .� v �. ©ASH *t I ✓` �v L� I� ❑OTHER ©OTHER SCHEDULING MUST BE MADE PRIOR TO a 00 P M/THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL_ONGOING LY DELIVERIES MUST BE SCHEDULED VATH THE LANDFILL THE DAY BEFORE SUBJEC'TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209)882-429e / MANIFEST. 65�$ TO SCHEDULE CALL 1209)982-4298 MANIFEST 0 56 59 9 GENERATOR COPY GENERATOR COPY