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I \ #),,,,FORWARD NON-HAZARDOUS WASTE MANIFEST WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. GENERATOR REQUIRED PERSONAL PRC7TECT11/E EQUIPMENT ❑GLOVES ❑GOGGLES ❑RESPIRATOR CHARD HA Jl MAILING ADDRESS ❑TY-VEK [:]OTHER SPECIAL HANDLING PROCEDURES: CITY,STATE,ZIP PHONE CONTACT PERSON SIGNATURE OF AUTHORIZED AGENT 1 TITLE DATE • WASTE TYPE RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL ❑ 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 (209) 982- 1009 FAX NAME NOTES: TRUCK NUMBER ADDRESS'` r CITY,STATE,ZIP END DUMP BOTTOM DUMP TRANSFER PHOiv .3 - ❑ El 1351bN""ATORE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ FORWARD INC. LANDFILL CUBIC YARDS Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD', impairs the safe and effective operation of the: Landfill. Forward shall Use reasonable efforts to promptly notify Disposer of its inability to accept the; DISPOSE BIO AERATE STM-KPILE OTHER waste for any reason. If Forward's refusal to accept the waste is based on weather or other site conditions,Forward shall notify the Disposer when site ❑ SOIL conditions are expected to change such that Forward will be able to accept the waste. ❑ SLUDGE ` `REMARKS ❑ NON-FRIABLE FACILITY TICKET NUMBER ASBESTOS ❑ WOOD SIGNATURE OF AUTHORIZED AGENT DATE ❑ ASH ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL w ANY UNSCHEDULED LOADS AR SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL (299)982-4298 MANIFEST# 19 R 7 9 d