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ON-HAZARDOUS WASTE MANIFEST"`"'` <br /> FORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. <br /> GENERATOR - ` 'vx " ='t REQ fF�E_D PERSONAL PROTECTIVE EQUIPMENTS``7-" ,O , <br /> ? yY1 r -e rt . _µ [f�GLOVES []GOGGLES []RESPIRATOR RD HAT <br /> MAILING ADDRESS xr ° ❑TY-VEK ❑OTHER <br /> 6o dC 1 "L Z *— - SPECIAL HANDLING PROCEDURES <br /> ITY,STATE,Zi <br /> PHONE <br /> CONTACT PERSON 4 `� <br /> SIGNATURE OF AUW IR ZED_AGENT%TITLE DATE:`,_A <br /> 7�C <br /> WASTE TYPE' �' _ RECEIVING FACILITY _ y <br /> SOIL E] NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> H46REATMENT DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL [-] ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY r (209) 982-4298 PHONE <br /> T t701CC (1 -ej)j,,,ft-- 1 rLA c.1G (209) 982- 1009 FAX <br /> NAME _ 5 w 3' NOTES _., . , , TRUCK NUMBS{ T <br /> ADDRESS <br /> • CITY,,, TATE, ZIP <br /> END_DUMR?.L ,. BC3TT0_M DUMW — -TRANS <br /> FEi qa <br /> El <br /> SIGNATRE OF AUTI-IORIZED AGENT OR DRIVER , DATA ROLE.�OPF(5) ,w.a FLAT SEI] <Vi4 Ill `L <br /> JL <br /> FORWARD INC. LANDFILL CUBI1 Vis;�r-;; „ tv,,, �js <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 �w (t0 BE COMPLETED BY FORWARD), <br /> impairs the safe and effective operation of the Landfill Forward shall use r -E , ) ra w <br /> reasonable efforts to promptly notifyDisposer of its inability to accept the +'" �'`'DISPOSE 1310 Abh TE sibcKPIL . <br /> waste for any reason If Forwards refusal to accept the waste is based onOTHER <br /> weather or other site conditions, Forward shall notify the Disposer when site <br /> conditions are expected to change such that f=orward will be able to accept <br /> the waste ❑ SLUDGE <br /> ` REMARKS <br /> NON-FRIABLE <br /> FACILITY TICKET NU�+IIBER ❑ ASBESTOS <br /> ❑ WOOD <br /> SIGNATUFtff AUTHORIZED Ad LE ax _ DAT--E <br /> A I� ❑ ASH <br /> 41 U J ❑ OTHER <br /> SC ULI UST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 4♦ A 0 C <br /> V <br /> GENERATOR COPY MANIFEST # 1 7 V <br />