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WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE N0. cIMI µ ,.k <br /> GENERATOR _ a _- n REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> THRIFTY 0 I L COMPANY _ _ ❑GLOVES [:]GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESS ' `"�``` `�" �` .=r - t.r CITY-VEK ❑OTHER <br /> 100000 LAKEWOOD MD. <br /> CITY,STATE,ZIP " '_' ter:''"-' '` _ �" _ SPECIAL HANDLING PROCEDURES <br /> DOIWNEY, CA 90240 W <br /> PHONE `- <br /> 310-923-9876 <br /> CONTACT PERSON " <br /> PETER O ' AMICO <br /> SIGNATURE OF AOTHOR_IZED AGENT/ TrrLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THPIPTY OIL (209) 982- 1009 FAX <br /> 1250 N . NILSON 14AY <br /> STOCY0T,1 , CA <br /> NAME NOTES TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESS <br /> 1336 PAULI,NE AVE . LOAD 425 <br /> CITY, STATE, ZIP <br /> '400EST1 , CA 95353 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-573-410C ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ' ❑ ❑ ❑ ❑ <br /> a 1 <br /> FORWARD INC. LANDFILL CUBIC YARDS <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 inability to accept the DISPOSE 610 AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on IL <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 /> • <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> • NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> * �� r <br /> ❑ OTHER <br /> SCH DULING UST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUB,�fi TO FUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 <br /> MANIFEST # 27655 <br /> - <br /> TRANSPORTER COPY <br />