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FNON0HAZ" DOUS WASTE MANIFEST <br /> ! , WASTE TRENT AND DISPOSAL FACILITY <br /> INC.7 JOB ACCEPTANCE NO. <br /> GENERATOR � REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> PFLOVES F]GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-ViK 0OTHER <br /> CITY,STATE, ZIP I SPECIAL"HANDLING PROCEDURES: <br /> PH <br /> OE ,' D <br /> coN�TAcPERSON N P�1996 <br /> J SIGNATURE OF AUTHORIZED AGET /TtTLE pATE ,j �M�NZF IGES <br /> lS�� <br /> : WASTE TYPE RECEIVING FACILITY <br /> i ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> PDISPOSAL SOIL ❑ WOOD 91999"!SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTEiCA, CALIFORNIA 98336 <br /> GENERATING FACILITY ;3(209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME (C // NOTES:" _J TRUCK NUMBER <br /> �fl, . Ir./ _ .3l`r�5 �/✓C/Yf GJ / �YC � � I ...- � / <br /> :'ADDRESS <br /> CITY,STATE,ZIP <br /> .!•�/ L7 <br /> { <br /> Sir/h ih r•1iG �fi CJ j€7E ,? <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 16 0 13 <br /> j SIGNAT <br /> URE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other II <br /> conditions impair the sate 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 use I <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE SIO AERATE StOGr.PiLE OTHER <br /> f 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 wilE be able to accept i <br /> J thewaste. ❑ SLUDGE ! <br /> REMARKS <br /> NON-FRIABLE <br /> „ ❑ ASBESTOS <br /> FACILITY TICKET NUMBER= <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE I, <br /> ❑ ASH <br /> k * ❑ OTHER 1 <br /> SCHEDULING MUST BE MADE PRIOR TO 4.00 P.M. THE DAY PRIOR, TO EXPFdTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARP[VAL. ONIGOING DAILY DELIVERIES?.LUST BE SCHEDULED V."ITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL (203) 982-42C-6MANIFEST 3 <br /> 765 <br /> C__-Pi' <br /> I <br /> i <br />