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. �! ■.���- ivvly~r �,-►t..ni ivvU� �rvey� I L IVIt11Vlt'CJ� <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE ISO. K <br /> wr'CMF� <br /> i <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT,.; - <br /> THRTFTY OIL COMPANY ~~ ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILIRG ADDRESS ' " '` a--` - "� �— �w= f`�` �' ❑TY-VEK ❑OTHER <br /> _ ; +e..1Q''�.....�i., M'tia:«c.s'�".n,ew=" v Y_�.�3.nz+�s_�Li:...'u <br /> 1fl0000 LAKEWOOD BLVIJ. ` ` <br /> CITY,STATE,ZIP ` - '-" ' ry '" "'"z "Ls� SPECIAL HANDLING PROCEDURES <br /> DOWNEY , CA 9024-01 <br /> PHONE <br /> 310-923-9876 _ <br /> CONTACT PERSON <br /> PETER D ' At4IC17 <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE T DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> {❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY OIL <br /> 1250 N . WILSON WAY (209) 982- 1009 FAX <br /> STOCKTON , CA <br /> NAME _ - NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING � <br /> ADDRESS <br /> 1336 PAULIBE AVE. LOAD #4 <br /> CITY,STATE ZIP ' <br /> • i400EST0 , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 213579X 209-573-4100 10 11 ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC Y,�RDSr <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inabiidy to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on Q SOIL ! <br /> weather or other site conditions Forward shall notify the Disposer when site <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER - - <br /> ASBESTOS <br /> E] WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> p ASH <br /> 7�CP �_,� I - ��I ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY SEFOiRE <br /> Ti�nHE4UL.E CALL (209)982-4298 MANIFEST # 2 7 6 3 4 <br /> TRANSPORTER COPY <br />