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NON-HP'4RDOUS WASTE MANIFEST <br /> WASTE 1 ;LATMENT AND DISPOSAL FACILITY <br /> INC JOB ACCEPTANCE N0. 5// -52 / <br /> GENEWOR Y . _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT .,--> <br /> One I�1 L t� �.I_ _ [:]GLOVES ❑GOGGLES []RESPIRATOR HARD HAT <br /> MAILING ADDRESS <br /> [:)TY-VEK ❑OTHER <br /> I • 5 box _50 of�. --- - . SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP M <br /> r <br /> • 5a n Pa r o n, <br /> PHON <br /> �a/Cl� �i72- '041 '- - - - - - - %votiE " <br /> CONTA T PE SON <br /> i�"andon <br /> SIGNATURE OF AUTHORIZED AGENT /TITLE 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 95336 <br /> • <br /> GENERATING FACILITY _ (209) 982-4298 PHONE <br /> �3cQQ( Flc��gqP�yTf O1 0C toad (209) 982- 1009 FAX <br /> y <br /> atD(1—�Y�CA <br /> NAME NOTES: TRUCK NUMBER <br /> � ct a Me ry <br /> ADDRESS <br /> • CITY STATE, ZIP <br /> PHONE _ 4 END DU P_ BOTTOM DUMP _ TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE y ROLL-OFFS)_ , „FLAT-BED_ VAN _ - DRUMS <br /> CUBIC rRO .i •r�� <br /> FORWARD INC. LANDFILL <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 FORVARD) <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 �,,;:,;,, -_ E BIO_ AERATE ISMCKPILd '_OTHER <br /> waste for any reason. If Forward's 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 --11 <br /> the waste. ❑ SLUDGE <br /> • REMARKS - <br /> _. . ,-.� . _•.' ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICK -{N MBE <br /> i ❑ WOOD <br /> SIGNATU11OF RIZlpb AGENT AA <br /> I� � ASH <br /> OTHER T/ '� �(� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4;OD,W.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 3067 7 <br /> MANIFEST # <br />