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�" WARD NON-hl, �ARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE N0. <br /> GENERATOR "St;'J9bQ l "5 ' 3` �,!I REQUIRED PERSONAL"PROTECTIVE EQUIPMENT <br /> []GLOVES []GOGGLES ❑RESPIRATOR El HARD HAT <br /> MAILING AD ESS Yrrku <br /> []TY-VEK ❑OTHER <br /> Y <br /> CITY-STATE ZIP - SPECIAL HANDLING PROCEDURES: <br /> - <br /> PHONE }<� n <br /> �d 7- .375 �y z <br /> • CONTACT PERSON .y..,,.-. ...-. ;:��a u 41._ M77] <br /> SIGNATUR OF AU. IZED AGENT/TITLE DATE ,,, <br /> ( ` <br /> '44-1 <br /> WASTETYPE _ a+ :- RECEIVING FACILITY <br /> , <br /> _ <br /> ❑ SLUDGE <br /> ' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL � 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERAT1fVG:FACIITY vtt �t_, (209) 982-4298 PHONE <br /> (209)982- 1009 FAX <br /> NAryIE 1� � . 5c�1 ro i NU41� <br /> . ADDRESS, ^ jE 1Zi <br /> • CITY�"STlt//*l)yaP,V(( TMSQf IT 1�}.l <br /> • Pf�ONE 4 :iso �' "END DUMPY t_g BQTTOM DUMP. TRANSFER <br /> El <br /> S GNAT F II _D AGENT OR DRI ...- 541 U.TE ,., O FF(S. �. �LT❑B�r.k A DRUMS. <br /> �k � �Q <br /> FORWARD INC. LANDFILL G"ED`"'x °$ ��"�" { " ` <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 ,DISPO L'M OD' ;,TO BEGOMPLETED,BY FORWARD; <br /> impairs the safe and effective operation of the Landfill. Forward shall use r _� - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _, . 'e; 3SE <br /> AERATE SrOGKPItE OTH_ER_: <br /> waste for arry 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 accept <br /> j the waste. ❑ SLUDGE <br /> • RE�AAR{CSSsrtya bLk3-' ^ '�,:.. *4'h. _& d_ <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> Faclii ;17�iZf{ _ BF TAW,fie , .ti fW�' wooD <br /> I SIG. ....., R 'QF,,UTH�RIZED:' <br /> . II ❑ ASH <br /> - _-\, _. — 4 ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS AF <br /> ,,SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFOR <br /> TO SCHEDULE CALL(209)982-4298 e,ner.nFr QT A 1 1 7 1 d <br />