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Am' WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL. FACILITY <br /> Aq/v '. JOB ACCEPTANCE NO. CMM - 1288 <br /> FGENERATOR - REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> IFTYSOIL COMPANY _ ❑GLOVES ❑GOGGLES ❑RESPIRATOR . El HARD HAT <br /> _ _ ❑ ❑OTHER T <br /> 0000 LAKEWOOD BLVD. SPECIAL HANDLING PROCEDURES <br /> ATE,ZIP <br /> WNEY, CA 90240 <br /> PHONE <br /> 310-923-9876 <br /> CONTACT PERSON _ <br /> R'RIMOXNAM190 PETER D ' AMIC <br /> SIGNATURE OF AUTHORIZED/AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> © DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> T'IR!c i Y OIL <br /> 12: F) . 4I LS N IVAY (209) 982- 1009 FAX <br /> S F 0C't@TN , CA <br /> NAME T <br /> I <br /> RICNOTES TRUCK NUMBER <br /> RICH -fA��+I1_ 101! R!�C`:I�IG 930ADDRESS <br /> 1.335 PAUL"[ 1E AVE . LOAD AAA <br /> CITY,STATE, ZIP <br /> %1ODE3 T irl , Cry X53 -)2 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> - 1-57,3-411)0 © 1:1 1:1 <br /> SIGNATURE OF AU ORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> El El El El <br /> �Z2l <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other Q� <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD ( O 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 C—t <br /> weather or other site conditions, Forward shall notify the Disposer when site 0 SOIL <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 /> / 1 ASH <br /> { � G ❑ OTHER <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 LANDFILLTHE DAYBEFORE <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # 2 7 6 O 3 <br /> GENERATOR COPY <br />