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Y ARD NON—HAZARDOUS WASTE MANIFEST <br /> k t' O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> fiATOR, f pgauisw PEANMAt PROTECTIVE EQUIPMENT <br /> QGLOVES ❑GOGGLES ❑RESPIRATOR HARD HAT <br /> MAILING ADDRESS.,.:- ❑TY-VEK ❑OTHER <br /> SPECIAL HANDLING PROCEDURES <br /> PHO <br /> NE .• <br /> CONTACT PERSON-- "' F" <br /> SIGNATURE OF{�UTH0 <br /> WASTE T Y P E _�jj RECE1171tJ© A <br /> _ f <br /> i <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 /> ! <br /> GENERATING FACILITY ,:{y .� ,_ , �;wYw (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME. _ {�, r w" s�" F�� - ryJ&5' NOTES=. �� " �^��t: ' TRUCK NUMBER <br /> ! � <br /> RESS=/ --. n � �{ ti�,n�w� � J� 'r• .. F'�.R-..ex f � rI 'JJ'� r /�f i <br /> ADD ,.•�r�. �+ '�jji e vel k F� <d µ � � � ��" \\ .� <br /> . <br /> CITY,S*fE,ZIP�t` < %�i1�°�i�t <br /> y <br /> PI TONE j. - Y ��; 3� �;END IJUMP� � �x f BOTTOM DUMP TRANSFER <br /> SIGNATUFE OF 1(LTHORIZED AGENT OR DRIVI3 DATE;� „, xOC 0 r;FL,4T-i3ED 6_ <br /> VAN w DRUMS <br /> r� ❑ ❑ ❑ ❑ <br /> i <br /> CUBIC YARDS`,"" <�, _t -- <br /> FORWARD INC, LANDFILL ° n <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 ,,- - <br /> DISPOSAL METHOD ,y�-(TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shalt use �.��,..,; ,� �,�„s2 , �.- - , <br /> reasonable efforts to promptly notify Disposer of its inability to accept the '_ice-z Y fit';: 666SE a BIO, AERATE ISTOCKPILE OTHER j <br /> waste for arty reason if Forwards refusal to accept the waste is based on SOIL <br /> weather or other site conditions Forward shall nota the Disposer when site j <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste _ SLUDGE <br /> REMARKS - _, r r ❑ <br /> F ❑ NON-FRIABLE j <br /> ASBESTOS <br /> ❑ WOOD <br /> SIGNATUJRE F` " �pnM P Tr DATE ^¢ i <br /> ORIZEDNT� <br /> ` El ASH j <br /> ❑ OTHER <br /> SCHEDULING MUST 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 i <br /> TO SCHEDULE CALL(209) 982-4296 MANIFEST # 80021 <br /> > •6F'Y <br />