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J NON;HAZARDOUS WASTE MANIFEST <br /> ( WASTE TR, VIENT AND DISPOSAL FACILITY <br /> �w+ <br /> w-� <br /> INE. JOB ACCEPTANCE NO. <br /> I <br /> I, <br /> !I GENERATOR � REWIRED PERSONAL PROTECTIVE EQUIPMENT <br /> t k u� — eve �[jp,�,e�1- - (�� , GLOVES []GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAIL NG A F3RESS /y TY VEK MOTHER <br /> 506 J� U rl' Vii i-C L,4 ii-L-- <br /> i SPECIAL HANDLING PROCEDURES: <br /> i CITY,STATE,ZIP <br /> k 1 PHON <br /> CONTACT PERSON d x = ' L <br /> SIGNATURE OF AUTHORIZED AGENT TITLE DATE <br /> � WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> - ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS ;,'FORWARD INC. LANDFILL <br /> }fl'DISPosAL SOIL [:1 wooD 9999 SOUTH AUSTIN ROAD <br /> -1 CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANECA, CALIFORNIA 95336 <br /> GENERATING FACILITY h! (20'9) 982-4298 PHONE <br /> (209) 982-1 009 FAX <br /> i - <br /> NAME NOTES: TRUCK NUMBER <br /> ADDRESS v C', ` LCr �Y `} <br /> CITY,STATE,ZIP 1'• f <br /> d " L PHONE END DUMP BOTTOM DUMP TRANSFER <br /> �1& Cl/ � ❑ ❑ <br /> 1, <br /> SIGNATURE OF AUTHORIZED AGENT IR DRIVEF{ DATE ROC FLAT-SED VAN DRUMS <br /> f ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL 11 <br /> i <br /> ' Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the sale and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <br /> r=' 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 STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> it weather or other site conditions,Forward shall notify the Disposer when site ❑ SOIL' <br /> conditions are expected to change such that Forward will be able to accept <br /> € - <br /> the waste. <br /> _] SLUDGE <br /> ;j REMARKS <br /> .; ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> i = _ ❑ WOOD <br /> 1 ` SIGNATURE OF AUTHORIZED AGENT DATE I <br /> - ❑ ASH: <br /> ❑ OTHER <br /> ,f <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY mSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE'SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CELL (204) 962-422F, MANIFEST# 4, 5 2 <br /> I <br /> � w <br />