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NON-HAZARDOUS WASTE MANIFEST .' <br /> iI1�D WASTE TREATMENT AND DISPOSAL FACILITY <br /> Ilt1'C_ JOB A F CMM — '12a8 - <br /> CCEPTANCE NO <br /> GENERATOR �_ �� '3_ __ _ .. } � . REQUIRED PERSQNAL PROTECTIVE,EQUIPMENTC.;�,, <br /> —THRIFTY _OIL_ COMPANY ❑GLOVES ❑GOGGLES [JRESPIAATOR ❑HARD HAT <br /> MAILING ADDRESSY`'�" � ''-;; `Y "�" "'" [:]TY-VEK ❑OTHER <br /> 100000LQ((fW[}QD BLVD, <br /> • CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> -," _ �_ ., <br /> • DOWNEY, CA 9©240 <br /> PHONE <br /> 310-923-9876 <br /> CONTACT PERSON' _ ''_'�- r <br /> PETER DIAMICO <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE -t <br /> WASTE TYPE, , RECEIVING FACILITY <br /> E - <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑f DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> C] CONSTRUCTION SOIL ❑ ASH ASH <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY OIL (209) 982- 1009 FAX <br /> 1250 N . WILSON 14AY <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> RICH HA"ILTON TRUCCINO <br /> ADDRESS <br /> 1-136 PAULI JE AVE . LOAD 4 23 <br /> • CITY,STATE, ZIP w <br /> '107EST' , CA 95252 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 20cl-578-4100 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT E'ED VAN DRUMS <br /> /ff �'' ^ ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuB��] Ds <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 of the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impa;rs 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 refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste r I ❑ SLUDGE <br /> REMARKS <br /> • NON-FRIABLE <br /> FACILITY TICKET NUMBER - ASBESTOS <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT i DATE <br /> [:] ASH <br /> (� } ( <br /> * ✓ '► 1 - �{�t ❑ OTHER <br /> SQLiF,OULWG 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 DRAY BEFORE <br /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # 2 7 6 5 3 <br /> TRANSPORTER COPY <br />