Laserfiche WebLink
�, ► PURWARD NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATE WASTE TR ENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO, <br /> GFRATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ±` ,�Fi�: �, fCf ,f, / dGLOVES QGOGGLES []RESPIRATOR ZC HARD HAT <br /> MAILING ❑ADDRESS TY-VEIL ❑OTHER <br /> F 6 i ' z /`� SPECIAL HANDLING PROCEDURES: <br /> CITY, STATE,AP ' <br /> PHONE <br /> CONTACT PERSON A <br /> SIGNATURE O�IkUTHORIZF� AGENT/ TLE DA <br /> WASTE T PE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> a DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> CONSTRUCTION SOIL ❑ ASH <br /> a <br /> ❑ <br /> STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILIT (209) 952-4293 PHONE <br /> ;f,�' �= �`,� (209) 952- 1009 FAX <br /> NAME TRACTOR LIC.# TRUCK NUMBER <br /> --� <br /> ADDRESS 7 ~ TRAILER LIC.# <br /> CITY,STATE,ZIP TRAILER LIC.# _w <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> CUBIC YARDS vrA <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 FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall useDISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason. If Forward's refusal to accept the waste is based on C] 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 /> the waste. ❑ SLUDGE <br /> REMARKS NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHECLUNG MUST BE MADE PR!OR TO 4:CO P.Nl. THE DAY PRIOR TO EXPECTE) A�ZRI`/AL • A,\l`( UNSCHEDULED LOADS ARE <br /> SI:SJECT 7-'_ PEi=USAL UPCIl ARRI14'AL. ONGOING DAILY DEL IVEF.IES MUST BETrc LANDFILL T'-!c DAY BEFORE <br /> TO SCHEDULE CALL ',209; 932-4298 GENERATOR COPY MANIFEST # C 6 5%7 71 <br /> F01{C9511N1­116-96 <br />