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FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> v►� I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. F_$66 -- _S-6 0 <br /> GENERATOR _ K ___—_ —_ REQUIRED PERSONAL PROTEIZE EQUIPMENT —HARD�� LSU.`1 l''►4� T� -- GLOVES <br /> 0 GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS _ _ ❑TY VEK ❑OTHER <br /> ` � 1- 66 ? ---------- - SPECIAL HANDLING PROCEDURES <br /> G NATE,ZIP _ <br /> PHONE <br /> CONTACT PERSON _ <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE - <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS _ FORWARD INC LANDFILL <br /> IEJ-DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> _GENERATING FACILITY —_ _ (209) 982-4298 PHONE <br /> �CA r�t�x� PuANi {209) 982-1009 FAX <br /> -22� ofJ 5, µ <br /> pi a/v r'A �36L <br /> NAME TRUCK NUMBER <br /> _ _ _— <br /> ADDRESS --- o�^ �t z T <br /> -72; <br /> ST , <br /> . CITY,STATE,ZIP--- <br /> = <br /> V Zr 57 Y 7 <br /> _ <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OFAUTHORIZED AGENT OR DRIVER DATE _ ROLL-OFF(§ _ _ _FLAT-BED_— _ VAN _ _pRUMS <br /> El 0 El <br /> FORWARD INC. LANDFILL CUB[C 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 Bl0 AERATE STOCKPILE OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site IL <br /> ' conditions are expected to change such that Forward w it be able to accept <br /> the waste ❑ SLUDGE <br /> — <br /> _ NON-FRIABLE <br /> F <br /> _ACILITY__TICKET_NUM_BER ❑ ASBESTOS <br /> _ <br /> —� _ _-- _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT - _ DATE_- _ <br /> ----- -—_--- - - ----- --- - --- - ❑ ASH <br /> 7k �CJ .�✓ ❑ 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 108705 <br /> 0 8 7 0 5 <br /> MANIFEST # <br /> k GENERATOR COPY }w <br />