Laserfiche WebLink
.� (& FORWARD � NON-HAZARDOUS WASTE MANIFEST <br /> I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. G I S - 500 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> A S 1\ S , � ,�, [ GLOVES [-]GOGGLES ❑RESPIRATOR �IARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> �` ,\-C,0 1 t_c, Q 5 � <br /> PHONE <br /> 209- 5c,CI - 3 Lf S <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> ■■ `� .moi[.... � i �✓ .s. r <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ES DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> r_1 CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAMENOTES TRUCK NUMBER <br /> ATC_ <br /> C_ T v) '7 <br /> ADDRESS l� <br /> 1ll7 Lovti1'x, \j` <br /> • CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ?-CI-1- 5 7%- Z Z Z ► ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> c <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 DISPOSE BIO AERATE STOCKPILE OTHER ` <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site ❑SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste [] SLUDGE <br /> • REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> [:1 WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> J �� ❑ ASH <br /> 7�C -;/ --- _ C r �� �, CC ❑ 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 ~� <br /> MANIFEST 7 ; g <br /> TRANSPORTER COPY <br />