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FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> > "7 WASTE TREATMENT AND DISPOSAL F <br /> 1 `.' C. t� F. F t_ Iti :� T F°. t) C3S AGILITY <br /> ACCEPTANCE <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ., ❑GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD HA <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> v <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT PERSON <br /> s <br /> SIGNATURE OF AUTH0131ZED AGENT r TITLE DATE <br /> WASTE TYPE" RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TI-EATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ( DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUC=TION SOIL ❑ ASH <br /> _# ❑ OTHER MATECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAMENOTES: TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE, SIF <br /> 0 r END DUMP BOTTOM ......... - - <br /> PHONE TTOM DUMP TRANSFER <br /> E ❑ o <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT(-BED VD DRUMS <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation,to ticcept the wasle if weather or etner <br /> conditions impair the safe and effective disposal of the waste or it the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <br /> Impairs the sate anc+ effc,acfive operation of the Landfill. Forward shall use DISPOSE [310 AERATE STOCKPILE OTHER <br /> reasonabie efforts to promptly notify Disposer of its inability to accept the <br /> waste for arry reason. If Forward's refusal to accept the waste is bas06 on ❑ SOIL <br /> vt ither or other site conditions, Forward shall nc;tify° the Disposer when site <br /> * conditions are expected to chsrttto such that Forwartii will be able to accept <br /> the.waste. ❑ SLUDGE <br /> REMARKS NON-FRIABLE <br /> 0 ASBESTOS <br /> FACIUTY TICKET NUMBER ❑ WOOD <br /> SIGNATURE OF AUTHORIZED,,AGENT DATE <br /> ❑ ASH <br /> OTHER <br /> SCFIEDULING I t3ST BE t L PI3ICR TD �I,U{T P.h . THE I AY FIiIOf Tt7 EXPECTED ARRI�JAL ANY UP IIEDULED LEADS AR <br /> SUB IECT TCt REFUSAL.L+f Cit,iRRIVAtn,C7NCTD1NCa Dtl3LY DELIVERIES MUST SES I EDULED WIT t THE LANDI 1LL THE DAY SEF'OR€ <br /> T $0HEDULE CALL.I909)952-4999 MANIFEST <br />