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RWARD `y NON-HA?ARDOUS WASTE MANIFEST <br /> WASTE =ATMENT AND DISPOSAL FACILITY <br /> /NCI JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MAILIT R -]GLOVES ❑GOGGLES [:]RESPIRATORESPIRATOR <br /> NG ADDRESS ❑TY-VEK ❑OTHER [:)HARD HA <br /> �. o ' P3 C) _ Sods - <br /> CITY STATE,ZIP _ SPECIAL HANDLING PROCEDURES: <br /> • � n A' arnon,Cx� .a�i533 <br /> PHONE <br /> CONTACT PERSON <br /> er-aniton Harr(s <br /> SIGNATURE_ F_AUM:9131413 AGENT/TITLE DATE <br /> • WASTE TYPE RECEMNG FACILITY , <br /> ❑ SLUDGE <br /> ❑' TREATMENT SOIL ElNON-FRIABLEASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • <br /> GENERATING FACILITY (209) 982_4298 PHONE <br /> 200 E (c�nfi <br /> M1 l e Roach (209) 982- 1009 FAX <br /> S�ocK-Ion , CA <br /> NAMECQt7Q I� C� »irk NOTES: TRUCK-NUMBER_ <br /> ADDRESS_ .__... '510 YS32 <br /> 2530 L3etr�es 4* 5ct'� fT819S3 <br /> • . CITY STATE,ZIP <br /> PHONE BOTTOM DUMP TRANSFER _ <br /> SIGNAT)IFjE OF.AUTHOR A R DRIVER DATES `- ppL_L_ OFF(S)_ FIAT-BED , VAN <br /> * LAW <br /> ❑ ❑ ❑ ❑ <br /> S <br /> FORWARD INC. LANDFILL CUBIC YARD - - - --- <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 BIO__,_ AERATE ISTOCKPLE' 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 6 SOIL <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> _ 2 <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER `" ASBESTOS <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT _ ' DATE <br /> _, <br /> - _ ❑ ASH <br /> ❑ 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 3065 <br /> MANIFEST # <br />