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VIVITw NON-HAZARDOUS WASTE MANIFEST <br /> I�/A <br /> RD WASTE TREATMENT AND DISPOSAL FACILITY <br /> ►NC. JOB ACCEPTANCE NO. Lf�j . - /3 y �°3 11 <br /> ENERATOR " ° _ n ` `dam RE UIRED PERSONAL PROTECTIVE EQUIPMENT <br /> {M__L I'�i1 -�E'� �W - Y 0. GLOVES C!GOGGLE S Q RESPIRATOR HARD MAT <br /> iVl rG AD R ❑TY-VEK ❑OTHER <br /> SPECIAL HANDLING PROCEDURES <br /> IjY STA E, If� <br /> ' 161 -/f.Jp�— �Y� , w , . <br /> - H ONE <br /> �!` i( -670 <br /> C NTACT P S N - <br /> Gy <br /> SIGNATURE OF AUTHORIZY_Dp iGENT /TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> �]TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982-- 1009 FAX <br /> AME 1/"lrZr NOTES �, a TRUCK NUMBER, <br /> L <br /> r � <br /> !!f✓, - �- � f <br /> ADDREss <br /> Ci <br /> • PHONE� � _ _ <br /> =� F END DUMP BOTTOM DUMP_ TFA FEF ' <br /> M�-, <br /> J � _ itl <br /> + SIGNATURE Of; AUTHORIZED AG�T OR DRIVER DATE F ❑ ❑ <br /> OLL OFF( )r LATrBED, AN <br /> 0 El El 0 <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL <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 IS SAL METHOCf �TO BE COMPLETED BY FORWARD) <br /> the safe and effective operation of the Landfill Forward shall use - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _ dISPO$E ;�10 AERATE STLIfPILE.. OTFIEI�m _ <br /> waste or any reason if Forwards refusal to accept the waste is based on <br /> .� _._ <br /> 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 /> the waste ❑ SLUDGE <br /> �--�.-,y---- <br /> ❑ NON-FRIABLE <br /> i=AdIL,ff-N T'1 .k rN st-R ASBESTOS <br /> _ <br /> WOOD <br /> 31©NATU E 6FAUT'�iORIZEf7 i�G9NT ;;�� DATE` �• !__ <br /> ++ / ❑ ASH <br /> ❑ OTHER <br /> SCI I _VUVING "T 13E MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS ARE <br /> St1Tt iFei `IU nEFU¢AI_UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCIIEDULED WITH THE LANDFILL THEDAYBEFORE <br /> TO SCIIEDULE CALL (209) 982-x€298 MANIFEST # 65 <br /> 6 5 <br /> GENERATOR Copy <br />