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WARD NON-HAZARDOUS WASTE MANIFEST <br /> FWWASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. CMM --- 1286 <br /> GENERATOR T REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> THRFT OTL COhkPAI�IY _ _ []GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING A RE S _ _ W _- _ ❑TY-VEK ❑OTHER <br /> 100000 LAKEWOOD BLVD. - SPECIAL HANDLING PROCEDURES <br /> CITY, STATE,ZIP <br /> ` DOWNEY , CA 99240 - <br /> PHONE <br /> 317-923-9976 <br /> CONTACT PERSON <br /> PETER D ' AMICO - <br /> SIG R OF AUTHORI D AGENT/TITLE DATE <br /> ' ,� <br /> jai 9� <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • p DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY <br /> (209) 982w4298 PHONE <br /> THrRTr=TY I]?L <br /> 125" ,i ,,r, S17lr1 14AY (209) 982- 1009 FAX <br /> STCIC�< rC;# , G4 <br /> NAME NOTES TRUCK NUMBER <br /> RICH HAMILTCI�,J TRUCKING <br /> ADDRESS L P A I) 4`51 q <br /> 1335 PAULINE AVE <br /> • CITY, STATE, ZIP <br /> • <br /> '100E ;TO , <br /> IIA 95_ 3� <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 2,) 1-7,3-h-LI 1�� ,❑ 1:1 1:1SIGNATURE`OF�JiA_0AIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> �k ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other 1 <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 /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> �' ❑ ASH <br /> rl��r [] OTHER <br /> SCHEDULM 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/THEE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # L f 6 V O <br /> GENERATOR COPY <br />