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s FORCOR WARD JOB ACCEPTANCE NO. NON-HAZ--�DQUS WASTE MANIFEST WASTE TREATMENT AND DISPOSAL FACILITY 79�' �trvtH REQUIRED PERSONAL PROTECTIVE EQUIPMENT O ® GLOVES ❑ GOGGLES ❑ RESPIRATOR ® HARD HAT MAILIN ADDRE j J ❑ TY-VEK ❑ OTHER z / CITY, STATE, O SPECIAL HANDLING PROCEDURES: ONE ) 3 &5 TNTACT PERSON ) et- SI'�UTHOR� I�ZE-D AG NT /ffLE �/(D WAJIt I YHt r .. _ RECEIVING FACILITY_.; ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL 1 B DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ASH , ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY / a- AD�, CITY,STAT , ZIP �o /, 9S 2 y'/-a3S 7 PHONE SIGNfA1TURE OF AUTHORIZED AGENT OR DRIVER JDATE FORWARD INC. LANDFILL Forward shall have no obligation Aaccept the waste if weather or other conditions impair the safe and effective {Disposal of the waste or if the waste impairs the safe and effective operation of the Landfill. Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the waste for any reason. If Forward's refusal to accept the waste is based on 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. REMARKS FACILIT`/*ZICKET NUMBER (209) 982-4298 PHONE (209) 982-1009 FAX NOTES: TRUCK NUMBER D EAD DUMP BOTTOM DUMP TRANSFER ❑ ❑ ROLL -OFFS) FLAT-BED VAN DRUMS ❑ ❑ ❑ Cl CUBIC 7S i DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) t - IDISPOSEI BIO I AERATE ISMKPILEI OTHER ❑ SLUDGE rvUN-rnweu ❑ ASBESTOS: ❑ WOOD SIGNATgRCOF AUTHORIZED AGENT DATE r y �\ ❑ L, ASH I—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 O 9 U 5 n p� MANIFEST# ,J