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ORWARD r"M_ NOW-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. tim�-fl <br /> NERATORr E;E } IRED_p56W- - -PROTECTNE EQUIPMENT <br /> Clef C D 1 r f O/*7 �j/[y [:]GLOVES ElGOGGLES E]RESPIRATOR [:]HARD HAT <br /> ❑ ❑ <br /> iLING ADDRESS TY-VEK OTHER <br /> n <br /> I f r A <br /> CITY,STATE,ZIPtr= SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> CONTA � SO� <br /> )u <br /> SIGNATURE OF R17EI7 AGEiVT%,Tffl ?i Fad r DATE <br /> 44 m <br /> WASTE TYPE - - "` ° `" RECEIVING <br /> ii' x a. a jdwa f ma syr t 7 i-v+.- ..1�1;.rS,.w• <br /> ❑ SLUDGE <br /> ❑ TREATMENT 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 /> I ( C� „- ;,� y (209) 982- 1009 FAX <br /> rC �C 0ti <br /> NAME / kT' �' .. r NOFES.y t�E:,:�c a �7��' r TRUCK NUMBER <br /> ADDRESS" <br /> CITY,STATE,ZIPS [. <br /> PHONESEND DUIwIage, BOTTOM DUMP TRANSFER <br /> _ �o d � � 5���Ms`s� ❑ ❑ ❑ <br /> '„ '` FtOE7S rw', fA�f--BED w- VAN. - DRUMS <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE 7 �, sf �Tr <br /> r . ❑ ❑ ❑ ❑ <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 DISPOSAL METHOD��� (TO BE COMPLETED BY FORWARD) <br /> 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 y 3 ! 45 DI5PC7$E -t'BIO AERATE STOCKPILE OTHER <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 /> REMARKS <br /> a NON-FRIABLE <br /> . A Y� ❑ ASBESTOS <br /> FACILITY,_TICKET NUMBtR ❑ <br /> WOOD <br /> SIGNATURE OF f7THOR[ZE6 AGI=NT <br /> E] ASH <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 <br /> TO SCHEDULE CALL (209)982-4298 p 0 n 3 0 <br /> MANIFEST # O t1 J <br /> IOLM tisPY <br />