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FORWARD NON-HAZARDOUS WASTE MANIFEST v. INCORPORATED ' WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. 3* + - GENERATOR_ w. REQUIRED PERSONAL PROTECTIVE EQUIPMENT _ _ 0jiLOVES ❑GOGGLES ❑RESPIRATOR UtARD HAT MAILING ADDRESS u ❑TY-VEK []OTHER _ _ _CITY STATE, ZIP_" - SPECIAL HANDLING PROCEDURES - PHONE Zog- 5 �C CONTACT PERSON SIGNATURE OF AUTHORIZED AGENT/TITLE DATE ,WASTE TYPE _ -, _ _ RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH • ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE (209) 982- 1009 FAX 'NAME _ _ NOTES TRUCK NUMBER A Tc- ADDRESS _ __ 5C 6 F 9145: ,...i STATE Zip M.QK tPHpNE END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT--BED _VAN DRUMS 0 ❑ El Z FORWARD INC. LANDFILL CUBIC YARDS_ Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) impwrs the safe and effective operation of the Landfill Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE1 BIO - AERATE STOCKPILE OTHER waste for any reason If Forwards refusal to accept the waste is based on IL weather or other site conditions Forward shall notify the Disposer when site • conditions are expected to change such that Forward will be able to accept the waste ❑ SLUDGE NON-FRIABLE _ y ❑ ASBESTOS FAGIUTY„_TICKET NUMBER ❑ WOOD SIGNATURE OF AUTHORIZED AGENT ❑ ASH f i; ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL (209) 982-4298 MANIFEST # 110787 GENERATOR COPY