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NOWHAZI `•DOUS WASTE MANIFEST <br /> TO <br /> WASTE TRENT AND DISPOSAL FACILITY <br /> 17, 1,4/A R-G u <br /> INE. JOB ACCEPTANCE NO. <br /> GENERATOR REgUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> --J(�2ll r�l�• ;1- , p GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ' MAILING DDRESS ❑TY-VEK []OTHER <br /> {1�'f 4cx��' <br /> CITY,STATE,ZIP SPECIAL':HANDLING PROCEDURES: �f <br /> PHONE <br /> CONTACT PERSON <br /> ` SIGNATURE OF AUTHORIZED AGENT /TITLE DATE <br /> € t WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL [] NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> DISPOSAL SOIL ❑ WOOD 9,999jSOUTH AUSTIN ROAD <br /> /CONSTRUCTION SOIL ❑ ASH 1 <br /> ❑ OTHER MANTE�CA, CALIFORNIA 95336 <br /> GENERATING FACILITY <br /> „(209) 982-4298 PHONE <br /> hj . r c� (21'09) 982- 1009 FAX <br /> 4 � <br /> NAME NOTES: TRUCK NUMBER <br /> /r p� JnC �j , <br /> ADDRESS ' �; r Z� �!J F J <br /> CITY,STATE,ZIP <br /> / <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROI L-OFFS) ` FLAT-BED VAN DRUMS <br /> El 11 11 <br /> { YA D - <br /> CUB C R S <br /> {I FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other I <br /> -!t conditions impair the safe and effective disposal of the waste or it the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD} <br /> 1 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 STXKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on !j <br /> ,i weather or other site conditions,Forward shall notify the Disposer when site ❑ SOIL'! <br /> Tti conditions are expected to change such that Forward will be able to accept <br /> thatwaste. ❑ SLUDGE <br /> Jr ii; i REMARKS <br /> ❑ NON-FRIABLE <br /> F ASBESTOS <br /> • FACILITY TICKET NUMBER <br /> :i <br /> _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ASH <br /> I <br /> ❑ OTHER <br /> .j <br /> ' SCHEDULING :.BUST BE MADE. PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL A14Y UNSCHEDULED LOADS ARE <br /> i <br /> SUEJECT TO REFUSAL UPON ARRIVAL. 01''GOING DAILY DELIVERIES t�UST BE SCHEDULED % ITH THE LANDFILL THE DAY BEFORE. <br /> j TO SCHEDULE CALL (209) 852-4298 MANIFEST# 4, 3767 <br /> � C=t:EFit.TO'w:Cv�'1 <br />