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.FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. — SOO <br /> GENERATOF�- ti _ REQUIR D#'E RSONAL PROTECTIVE EQUIPMENT - <br /> -� _ ❑GLOVES ❑GOGGLES RESPIRATOR ❑HARD HAT <br /> Nelson Read hili x _ _ __ ._ _ - �_ __ <br /> MAILING ADDRSS' , _ ; ❑TY-VEK ❑OTHER <br /> - D - <br /> P.O. �QX�29 r= _� ` _��__ �_ W Y —__ �_ SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZiP <br /> RiPon, -M--95366— <br /> PHONE <br /> 209-466-288.4_ <br /> CONTACT PERSON - <br /> Russ_RelspnRIZ _ _ E <br /> SIGNATURE OF AUTHOED AGENT'/TITL _ 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 953365_,-,' <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> Nelson Ready ntx Concrete Plast 2 09) 9'82-1009 FAX <br /> 2700 S. Hwy�99 ` _ <br /> 'pon, CA 95366 <br /> NAME _ _ _ _ NOTES_ TRUCK NUMBER <br /> Bch_Ratilt�Trackinc -- - --- - -Q�Q_- <br /> ADDRESS- <br /> • 1217 S. _7thJgtrett <br /> . CITY,STATE,ZIP - �_- _ _ _ __--- _ IV 4 G s- al <br /> Modesto, CA 95351 -- <br /> PHONEEND DUMP BOTTOM DUMP `TRANSFER <br /> ' 209-57B-4100 - A __ _-, - ---_--- - - ----_ - © _ -- - - -- -❑- -- -,--- -r ❑ - <br /> " SIGNATURE OF AUTHORIZED A tf OR©RIVER DATE - ROLL'-`DFF(S) FLAT-BED _VAN DRUMS <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL — - - <br /> Forward shall have no obligation to accept the waste I 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 /> - - ' — --- - <br /> ❑ NON-FRIABLE <br /> FACILITY TIGKEf NUMBER ASBESTOS <br /> _ - __ __ _ _ _- - - - - ❑ WOOD <br /> SIGNATURt OF AUTHORIZED AGENT µ y DATE - _ , <br /> _ _ -__ -_- ❑ ASH - - - <br /> 7k _t / } / ❑ OTHER 4 <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE <br /> DAY BEFORE <br /> TO SCHEDULE CALL. (209)982-4298 MANIFEST# 16 J 5 V <br /> GENERATOR COPY <br />