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IVUIv-rIALAhUVUJ VVA61 t MANIFEST <br /> WA Jr WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. CMM *!'1288-=y <br /> GENERATOR _' ^ ; _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT i <br /> THRIFTY OIL COMPANY _ [-]GLOVES ❑GOGGLES [:]RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS - �"`f� Y' -'� ``'- _ " ❑TY-VEK ❑OTHER <br /> �- "M � <br /> 100000 LAKEWOOD BLVD ._ <br /> CITY,STATE,ZIP _ =% _ ' fi"' - =; _ SPECIAL HANDLING PROCEDURES <br /> DOWNEY , CA 90240 <br /> PHONE <br /> 310-923-9876 <br /> CONTACT PERSON _ <br /> PETER D ' AMICO <br /> SIGNITURE OF AUTHORIZED AGENT/ TITLE DATE <br /> WASTE TYPE } RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> ' ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> THRIFTY Y OIL 209 982- 1009 FAX <br /> 1250N . WILSON WAY � ( ) <br /> STOCKTON , CA <br /> NAME NOTES TRUCK NUMBER <br /> ADD ICH HAMILTON TRUCKING <br /> 1336 PAULINE AVE . LOAD 427 <br /> • CITY, STATE, ZIP <br /> '19DESTO , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-579-4100 )U ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> f ❑ ❑ ❑ ❑ <br /> Z/- <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shaft have no obligation to accept the waste ff 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 Drsposer of iLs inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on OIL <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 /> _ <br /> FACILITY TICKET NUMBER ASBESTOS <br /> a ❑ WOOD <br /> SIGI A RE AUTHORI D AGENT, DATE <br /> � �—.-- r <br /> ❑ ASH <br /> 7k <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL 0 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 # G 7 v 5 7 <br /> TRANSPORTER COPY <br />