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IVUIN-rIHL/AhUUU� VVH51 t MAWE6 f <br /> F,%'W' WARHWASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. <br /> r GENERATOR '` Y .x.. ._ ,"= REQUIRED PERSONAL PROTECTIVE EQUIPMENT ` <br /> THRIFTY OIL COMPANY ❑GLOVES ❑GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING ADDRES4 "', "�'� '�-�` '''' U a-' - '❑TY-VEK ❑OTHER <br /> w ....�.1. ws..:scr ' ' ...i �:r.ai.Q. <br /> 100000.�L.4C.�OxW ]QQ BLVD. <br /> CITY,STATE,ZIP_ <br /> SPECIAL HANDLING PROCEDURES <br /> • DOWNEY, CA 4© <br /> -902 <br /> PHONE - <br /> 310-923-8876 - <br /> CONTACT PERSON <br /> PETER D ' AMICO <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE <br /> 7k ` <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY - (209) 982-4298 PHONE <br /> THRIFTY OIL 209) 982- 1009 FAX <br /> 1250 N . NILSON 14AY <br /> STOCKTON , CA <br /> NAME NOTES` TRUCK NUMBER <br /> RICH HA!3ILT0tI TRUCKING X30 <br /> ADDRESS <br /> 1336 PAULINE AVE . LOAD 4 30 <br /> • CITY, STATE, ZIP <br /> tAODESTO , CA 95353 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 El El SIGNATUREEl_ OF AUT "RIZED A ENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> j) _ / ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> /� •� <br /> Forward shall have no obligation to accept the waste if weather or other f S <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METRO (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 refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when siteS75n� <br /> conditions are expected to change such that Forward will be able to accep <br /> • the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATtIq�IQF A THOR1Z D AGENT DATE <br /> ❑ ASH42 <br /> 9 <br /> ❑ OTHER <br /> l <br /> SCHEDULING 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 # 27660 <br /> TRANSPORTER COPY <br />