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'f•OHM NO WMfl1 f_.�ad <br /> WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> ,w va-W <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GEN TOR REQUIRE]PERSONAL PROTECTIVE EQUIPMEN y _Ljrj;- <br /> T H RI F TY 0 I L C O M P A N Y ❑GLOVES [-]GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESS _ �^ _ ❑TY-VEK ❑OTHER <br /> 100000 LAKEWOOD BLVD . <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> + DOWNEY , CA 90240 <br /> PHONE <br /> 310-923-987S <br /> CONTACT PERSON <br /> PETERD ' "iCO <br /> SIGNATURE OFA T'ORIZED AGENT/TITLE DATE <br /> WASTE TYPE , RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE ' <br /> TH;gI'FTY OIL (209) 982- 1009 FAX <br /> 125IJ "I I17LS9'l 4AY <br /> 5TOCKTON 1 Chi <br /> NAME NOTES TRUCK NUMBER <br /> ADDRESS�� HAMILTON TRUCKING G � <br /> 2336 PAULINE AVE . L3AG # 97 <br /> • CITY, STATE,ZIP <br /> iOO;73TG , CA 95358 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 2'09-5I, -4AL00 © ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBICfYA14DS <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 BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on.--- E] SOIL <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 /> r REMARKS <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ' ! ❑ WOOD R <br /> SIGNATU,AE IPP AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> _ ��' ` 'rL' ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO +b0 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 DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST # 2 7 6 6 8 <br /> GENERATOR COPY <br />