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�A�O ,� NON-HAZ... DOUS WASTE MANIFEST <br /> F&RWASTE TREATMENT AND DISPOSAL FACILITY <br /> Mr. JOB ACCEPTANCE N0. /z// <br /> ,GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> jq-I--f G /r E /L [-]GLOVES ❑GOGGLES [:]RESPIRATOR HARD HAT <br /> MA/IJ`L�IGvvADDRESS ❑TY-VEK ❑OTHER <br /> .CITY, STATE, ZIP <br /> // ,,,, SPECIAL HANDLING PROCEDURES: <br /> ../. gip/ <br /> PHONE <br /> �C 9 - 'fir- _l ?.�'_7 _ <br /> C TCT PERS -_ <br /> SI #T R F A TH RIZED AGENT / TITLE DATE <br /> • WASTE TYPE RECEIVING FACILITY- - <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • M DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> F-1 CONSTRUCTION SOIL ❑ ASH ASH - <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERAl1NGFACrtiry (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME V Z 11­, NOTES' w: T , <br /> _� { }, <br /> ' URM <br /> -ADDRESS '1 . � '•:- <br /> . CITY,?TATE �ZIF` <br /> r PO <br /> PH� NE END DUMP BOTTOM DUMP TR:\NSFER <br /> . _ <br /> SIGNATURE OF H RIZED GEN OR DRIVER DATE ROLL-OFF(S) FLAT-BED❑ VAN C RUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <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 :=ORWgRD <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 STOCKPILE 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 ❑-SOIL <br /> conditions are expected to change such that Forward will be able to accept . <br /> • the waste. ❑ SLUDGE <br /> • W_ EMARKS"� <br /> ❑ NON-FRIABLE <br /> � <br /> ar ASBESTOS CICITY.TIC10E�f's � R r r� f . <br /> u.., .. � <br /> El WOOD <br /> SIGNA�'tr4ER df )ZED AGENT i` DATE <br /> ❑ ASH <br /> Ii <br /> /❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00'P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED :.OADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE D :f BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 7 Q 3 n <br /> MANIFEST # C: l7 <br />