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F OR WA NON-HAZARDOUS WASTE MANIFEST I ;A C C7 R P O RA 'T E I) WASTE TREATMENT AND DISPOSAL FACILITY 3 JOB ACCEPTANCE NO. GENERWf0R REQUIRED PERSONAL PROTECTIVE EQUIPMENT tati ❑GLOVES ❑GOGGLES []RESPIRATOR HARD HA MAILING ADDRESS []TY-VEK [-]OTHER CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES. - PHONE R �4 CONTACT PERSON SIGNATURE OF AUTHORIZED AGENT / TITLE DATE WASTE TYPE RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT `TOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE "r (209) 982- 1009 FAX NAME NOTES: I TRUCK NUMBER t"r ADDRESS CITY, STATE,ZIP PHONE _ END DUMP BOTTOM DUMP TRANSFER S,)GNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ FORWARD INC. LANDFILL cuBlc YaRDS Forward shall have no oblicketion to accept the wr3ste if weather or other conditions impair the safe ana effective disposal of ttie waste cr if the waste DISPOSAL METHOD: (TO BE COMPLETED BY-FORYVARD) ifrrpairs the safe and effective operation of the Landfill. Forward shall use DISPOSE BIO AERATE ISTOCKFILE OTHER reasonable efforts to promptly notify Disposer of its inability to accept the waste for any reason. If Forward's refusal to accept the waste is based on ❑ SOIL weather or other site conditions, Forward shall notify the Disposer when site conditions arc; expected to change such that Forward will be able to accept the waste. ❑ SLUDGE R MARKSNON-FRIABLE ❑ ASBESTOS FACILITY TICKET NUMBER ❑ WOOD SIGNATURE OF AUTHORIZED AGENT DATE ❑ ASH ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS AR SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING{DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORI TO SCHEDULE CALL (209)882-4298 MANIFEST * 2