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F 0 RWA R V NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TRE. ..HENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> � 3 <br /> �ENERATOR, REQUIRED.PEeve �u��� ! [ r �f�% ]GLOVES ❑GOGGLES [:]RESPIRATOR ❑HARD HAT <br /> AILING ADDRESS ' / ❑TY-VEK ❑OTHER j <br /> ACX l Z ,' �. <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> - PHONE <br /> 07 <br /> CONTACT PERJN <br /> m4rk G-(fWc. G�' <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> * /Sr- 574rr .o( g� Q -q 17 . <br /> WASTE TYPE RECEIVING FACILITY� r°x `= •{ ' <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 953;36 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 6-e-wekr Foo (209) 982- 1009 FAX <br /> ` �' J �� Cir r l 1 t!{ [� •l �E !l r �:.�,J:. <br /> AME 'NOTES: :r <br /> �Ifa�cr Gea kvIvvnwef'z a � <br /> ,ADDRESS <br /> CITY,STATE,ZIP Si5_2 <br /> -5Z /7h1 , � 1/ 6 ? S <br /> r: <br /> I< PHONE END DUMP M_.W <br /> erx <br /> �S( -02(�� ❑ o ❑ <br /> SIGNATURE OF AUTHORIZED.AGENT OR DRIVER DATE ,ROLL-OFFS) <br /> .. ❑ ❑ ❑ IT <br /> G <br /> If <br /> CEJE3IC`,YARDS ,' K <br /> FORWARD INC. LANDFILL �Yu1M <br /> Forward shall have no obligation to accept the waste if weather or other 7 r 1 <br /> conditions impair the safe and effective disposal of the waste or if the waste DISi?OSAL':METHD <br /> impairs the safe and effective operation of the Landfill. Forward shall use 11�+ <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason. If Forward's 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 NON-FRIABLE- ❑ ASBESTOS <br /> FACILITY TICKET,NUMBER . <br /> WOOD <br /> IGNAT ORIZE �AGENT,a� �t DATE - 3% <br /> ,._..., -..._ ❑ ASH <br /> -�;CHEDULiNG MUST BE MADE PRION TO 4:00 P.P. 'HEDAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED"LOADS'ARE <br /> 3L'BJECT TO REFUSAL UPON ARRIVA .ONGOI DAILY i.J:'LiVERIES MUST BE SCHEDULED WfTH•THE LANDFILL:THE DAY BEFORE. <br /> O SCHEDULE CALL (209 982-429 MANIFEST# 58 0 2,v '- ;- <br />