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������� IV�I.JIV—i INLf`1f-tUVu� VIINJ I C iVIHIVtI—051 <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE N0. i20$ `= -'� <br /> { <br /> GENERATOR _ , r ' < w -� REQUIRED PERSONAL.PROTECT [JIVE EQUIPMENT. <br />• THRIFTY_-OIL COMPANY ❑GLOVES ❑GOGGLES [❑RESPIRATOR HARD HAT <br /> DRESS <br /> MAILfNG AD ` L'_- k �x p _�4 rr }� L x�`. <br /> _u,r�_ . -� g TY-VEK OTHER <br /> 100000 LAKEWOOD BLVD. <br /> . CITY'STATE, <br /> SPECIAL HANDLING PROCEDURES <br /> + DOWNEY, CA 90240 <br /> PHONE <br /> 310-923-9876 <br /> CONTACT PERSON <br /> PETER ' AM#;XO - - <br /> SIG4AT RE OF UTHORIZED AGENT/ TITLE DATE <br /> WASTE[TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DISPOSAL SOIL ❑ WOOD <br /> ❑ <br /> CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> + <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> TIaRIPTY OIL <br /> 1250 N. WILSON 'AIA'( <br /> (209} 9 82- 1009 FAX <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> ADDRRICH HAMILTON TRUCKING �3 <br /> 1336 PAULINE AVE. LOAD 115 <br /> • CITY, STATE ZIP <br /> HODESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-576-4100 ❑ ❑ ❑ <br /> SIGNATURE OF AU ORIZED GENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> El El El El <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other 'Pic- <br /> conditions impar the safe and effective disposal of the waste or if the waste DISPOSAL MET HO (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall Esse <br /> reasonable efforts to promptly notify Disposer of tts inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forward s refusal to accept the waste is based on <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 /> i <br /> REMARKS ` <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT 1 DATE ! <br /> ❑ ASH <br /> i+ ❑ OTHER <br /> SC ,9)UL1lN9VIMUST 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 DRAY BEFORE <br /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # 27646 <br /> TRANSPORTER COPY <br />