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j20#,.,F0RWAW_ NON -HA; "�DOIJS WASTE MANIFEST <br />INCORPORATED WASTE TRtATMENT AND DISPOSAL FACILITY <br />JOB ACCEPTANCE N0. <br />GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />-_ -- ; - ❑ <br />❑ <br />GLOVES [:1 GOGGLES RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS _ ❑ TY-VEK ❑ OTHER <br />C1TY,STATE, ZIP SPECIAL HANDLING PROCEDURES: <br />PHONE y <br />CONTACT PERSON <br />SyIGNATUREF�1UT�d©RI7,E <br />AGENT/ TITLE DATE <br />7C J j� aster ED n o r c`i': t r J f i� ,l J None <br />WASTE TYPE RECEIVING FACILITY <br />❑ SLUDGE <br />❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL <br />• ❑ DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br />❑ CONSTRUCTION SOIL ASH <br />❑ OTHER MANTECA, CALIFORNIA 95336 <br />• <br />GENERATING FACILITY (209) 982-4298 PHONE <br />Loves #223, 1553 Colony Rd., Ripon, C (209) 982-1009 FAX <br />NAME NOTES: TRUCK NUMBER <br />110 L <br />ADDRESS <br />. • CITY, STATE, ZIP <br />PHONE END DUMP BOTTOM DUMP TRANSFER <br />t 2 iJ... ; :- 6"-'C'_ E 3 <br />El El 11 <br />SIGNATURF,,45F AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br />❑ ❑ ❑ ❑ <br />FORWARD INC. LANDFILL CUBIC 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 Forward's 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 />s `r NON -FRIABLE <br />❑ ASBESTOS <br />FACILITY TICKET NUMBER <br />❑ WOOD <br />SIGNATURE OF AUTHORIZED.AGENT D&E <br />�; / </ / ` ❑ ASH <br />�k �--- "% ��,�' is " �� `f '� i� � ❑ <br />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 LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL -(209) 982-4298 <br />MANIFEST # 126431 <br />GENERATOR COPY <br />