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FtWWARD � T- � — Ivvlv—nr�tHrtuvuJ vVHJ I t IViHIVIrtJ f <br /> ■,.i.µ.`Mrs <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NQ. cKV� == ,2 & ' <br /> GENERATOR L +' M REQUIRED PERSONAL�PRQTECTIVE EQUIPMENT ; <br /> THRIFTY OIL COMPANY _ v ❑GLOVES`❑GOGGLES ❑RESPIRATOR [I HARD HAT <br /> MAILING ADDRE,5S-',%�F": 1 s 4{ '��t� R `, 4�w ❑TY-VEK ❑OTHER <br /> -100000 LAKEWOOD BLVD. <br /> CITY,STATE;ZIP' ``' 'rr " ��u -4z�—� = SPECIAL HANDLING PROCEDURES <br /> D O W N E Y,� CA 90240 <br /> .:.,.�.- .��`r �-� ��-r -- -- <br /> • PHONE <br /> 310-923-9876 s <br /> CONTACT PERSON - - <br /> PETER D ' AMICO <br /> SIGNAT*E OF AU HORIZED AGENT/TITLE DATE <br /> I i <br /> ■■ WASTE]TYPE RECEIVING FACILITY <br /> a <br /> ❑ SLUDGE <br /> ■ ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> �] DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> F-1CONSTRUCTIONSOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> w <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1250 N. WILSON <br /> 209) 982- 1009 FAX <br /> 1250 N. '�tILSO'd ��IAY <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> RICA! HAIIILTON TRUCKING <br /> ADDRESS <br /> 1336 PAULINE AVE . LOAD 4 17 <br /> • CITY, STATE, ZIP <br /> "ODESTO , CA A43X 95359 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 295-578-4100(, ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other �T <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 inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusat to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site 1L <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> + REMARKS <br /> ■ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT DATE <br /> l ❑ ASH <br /> `' ❑ OTHER <br /> SCHEQ�9JNGJAJST 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 DEUVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO'SCHEDULE CALL (209) 982-4298 _ r� <br /> MANIFEST # Z 7 6 v 4 <br /> TRANSPORTER COPY <br />