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NON-HAZARDOUS WASTE MANIFEST <br /> FORWARD <br /> v►o I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. S6 C _ <br /> GENET- 1�- --- REQUIRED PERSONAL PROTEGTIVEEQUPME�NT <br /> Nelson e _ [GLOVES ❑GOGGLES ❑RSPIRATOR - ❑-HAR_D_HAT_ <br /> MAILING ADDRESS - ❑TY-VEK ` ❑OTHER <br /> - _ - --_.�3333 _-r _�.__. _-_ _._3333 , _ <br /> 29 t - ` .-- --_ _ . __ SPECIAL HANDLING PROCEDURES <br /> A <br /> CITY STATE, P - <br /> Ri.poari, - <br /> - PHONE <br /> ; <br /> ' 209--466-28$4 - <br /> CONTACT PERSON <br /> Russ Nelson _'_ _ _ _ <br /> - � r <br /> SIGNATURE OF AUTHORI_ZED AGENT I TITLE Y_ DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> 9] DISPOSAL SOIL ❑ WOOD 9999-SOUTH AUSTIN ROAD <br /> El CONSTRUCTION SOIL ❑ ASH , - _ <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY _ _ _ _ _ _ -__ (209) 982-4298 PHONE <br /> Nelson Ready Mix Concrete Plant, <br /> 22700 S. Hwy 99 _(209) 982- 1009 FAX <br /> Ripon, CA 95366 <br /> NOTES _ TRUCK NUMBER <br /> Rich Hain_i3tc�i;I T�ck�.ng - ---! ��-�-- ---_ <br />' _AbDRESs_ <br /> 1217 S. 7th Street - <br /> . CITY STATE,ZIP __ _ �� --- -- -- --- - --- - -- - CS-LI io 0 <br /> Pit esto,_a 95351 <br /> END DUMP BOTTOM DUMP TRANSFER <br /> 209-578_-41_F6_0 - - --- - --- - - - ---- - - - - -END - - ❑ — ,------ '- b <br /> SIGNATURE OAUTHORIZED_AGE-r OR DRIVER DATE _ - ROLL-OFF(S) __ - FLAT-BED- — VAN- DRUMS <br /> * 8111-99 E] ElEl <br /> _ El <br /> FORWARD INC. LANDFILL CUBIC YARDS_ <br /> Forward shall have no obhgahon to accept the waste if weather or other 4 - <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 sate and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the - _ DISPOSE -1310 AERATE STOCKPILE -OTHER_ <br /> waste for any reason If Forwards refusal to accept the waste is based on �,u�r - - - <br /> weather or other site conditions Forward shall notify the Disposer when site ❑,861L 1 6 { <br /> ' conditions are expected to change such that Forward will be able to accept - Y' <br /> the waste ❑ SLUDGE kt <br /> ` REMARKS <br /> _-_ _ - ___-- _ --_ ------- - ❑NON-FRIABLE <br /> FAGr[LITY TICKET NUMBER _ASBESTOS _ <br /> r ,_— -� ❑ WOOD J <br /> SIGNATURE OF AUTHORIZED AGENT � - � — DATE—tl <br /> __ -`- ! El ASH <br />-J *.. ! J d r ► 1 ❑ 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 MANIFEST # 76555 <br /> GENERATOR COPY <br />