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NON-HAZARDOUS WASTE MANIFEST <br /> WARD a WASTE TREATMENT AND DISPOSAL FACILITY <br /> vr. JOB ACCEPTANCE NO. cmm <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT 14 —LJU,,i k <br /> THRIFTY OIL COMPANY - __ ❑GLOVES [_]GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [—]OTHER <br /> 100000 LAKEWOOD BLVD— SPECIAL HANDLING PROCEDURES <br /> CITY,STATE, ZIP <br /> • DOWNEY, CA 90240 <br /> - PHONE <br /> - 310-923-9876 <br /> CONTACT PERSON <br /> PETER D ' AMICO <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • [J DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1212 5 ) �iL (209) 982- 1009 FAX <br /> NAME NOTES j TRUCK NUMBER <br /> RICH HAMILTON TRUCKING rr <br /> ADDRESS Q 0 <br /> 1335 PAULTNE AMIE L SAD r 42 <br /> CITY,STATE, ZIP <br /> %h 15353 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 2C,-i--5 ';3-3 l,1 ca Q ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC, LANDFILL cUBJc„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 BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on ❑ 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 /> • REMARKS <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHE60LING-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 DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST # 2 7 V f7 4 <br /> GENERATOR COPY <br />