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jr2ftNON-HAZARDOUS WASTE MANIFEST' <br /> WA- RD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC JOB ACCEPTANCE N0. <br /> GENERATQR E� I I FGLLOVES <br /> IRED PERSONAL PROTECTIVE EO�IIPMENT,�'A`� g 'r <br /> [,[l <br /> 14,( V v� /�� ❑GOGGLES ❑RESPIRATOR jb&RD HAT <br /> M�A ADDR SSe�e _ -VEK ❑OTHER <br /> '6ITY,'A)JE, P - SPECIAL HANDLING PROCEDURES <br /> • za <br /> PHONE <br /> W J <br /> C NTACT PER ON <br /> G,✓ U4-1 Gtr <br /> SIGNATURE �?P AUTHO$IZED Ai� NT / TITLE DAYIrVJ <br /> * --11 7 /z_ jI9Zl <br /> .. <br /> WAS E t ! ' RECEIVING FACILITY <br /> ✓ f <br /> ❑ SLUDGE <br /> eTREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> °� r/ Ire, ' �`����� ' ` `> (209) 982- 1009 FAX <br /> AME,, .._.. _ �f NOTES_ � � � 5 � � � XTRLICK NUMBER,a, <br /> A6DRE SS <br /> StATE,ZIP <br /> Nod �?0,,..-_..r;,G�-.; _�' .�� . <br /> END DUMP BOTTOM DUMP TP V� 11 <br /> ` <br /> El <br /> SIGNAfuRE OF AUTHORIZED AGENT OR DRIVER DATE ROLL OFFS} , . FLAT--BED eVAN U_ <br /> El 11 11 0 <br /> t <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other / <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL-METHOD' � (TO BE COMPLETED 8Y FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use W r. , ° _ XEFlA� 8T 60i OTHER <br /> jreasonable efforts to promptly notify Disposer of its inability to accept the r, _ y',DISPOSE `.bB10 <br /> waste for any reason If Forwards refusal to accept the waste is based on ❑ SOIL <br /> weather or other site conditions, Forward shall notify the Disposer when site <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHbRlkt=D AdEiN -" <br /> _ f _/,( ❑ ASH <br /> ❑ OTHER <br /> SOI IEOULINf3'MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS AnE <br /> SO JECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCIIEDULE CALL (?_A9) 982-4298 MANIFEST # 6564 <br /> GENEFIATOR CORY <br />