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(Jill) FORWARD a NON—HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. w"� vr �`Y <br /> GENERATOR REQUIRED PERStDNALPAOTECTIVE EQUIPMENT <br /> ,, y s^ L }GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING A1�i5RE5S_ 1- T _ �, s i ❑TY-VEK : OTHER <br /> CITY,STATE,�ZIP �'; " �.1 } = ` _".�_��4,`N"t"�" SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> �titi— ar e^ <br /> CONTACT PERSON <br /> SIGN0,�URE OF AUTHORIZED AGENT! TITLE DATE _ <br /> ' � r <br /> WASTE TYPE ` RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ AU SOIL El WOOD SOUTH AUSTIN ROAD <br /> ElCONSTCONSTRUCTIONSOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME _ y ' - NO7rES-- TRUCK NUMBER <br /> z-7 p <br /> i <br /> ADDRESS` �- - - ! �. -fIj <br /> . CITY,STATE;71P - <br /> - <br /> PHONE_''- ' -,.n <br /> -- { , END DUMP BOTTOM DUMP TRANSFER <br /> — ` •® ❑ ❑ <br /> SIGNATU_I EQ AUTHORIZED AbENT OR bRIVE DATE _F - _ ROLL.-OFF(S),. Y a FLAT-BED - VAN DRUMS <br /> � tE31:1 El 11 <br /> FORWARD INC, LANDFILL cuslc YARDsr-�} .� - <br /> 1 <br /> Forward shall have no obligation to accept the waste if weafher 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 %fir - , ,, _ <br /> DiS OSE SIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the ;v'7s�,�;,�,,,:F�,,,,,,� „ w� <br /> waste for any reason If Forward's refusal to accept the waste is based on ,.,�L <br /> weather or other site conditions Forward shat; notify the Disposer when site L3`5VI <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ <br /> . t„� SLUDGE <br /> REIAARKS7 r <br /> • NON-FRIABLE <br /> FACILITY TICKENUMBERa, w � ❑ ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZEb AGENT _r37 <br /> sn <br /> ❑ ASH <br /> r= i ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 Dp P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE i <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE l <br /> TO SCHEDULE CALL (209)582-4298 8 0 0 9 0 <br /> MANIFEST # <br /> 811111111im!o4'Y <br />