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F 0 RWA EDNON-HA",,,RDOUS WASTE MANIFEST <br /> ►� I NCO RPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. - 4635 <br /> GENERATOR REQUIRED,PERSONAL PROTECTIVE EQUIPMENT <br /> S RE INC [:]GLOVES ❑GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESS ❑TY-VEK []OTHER <br /> 11328 DUBLIN BLVD . <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> e DUBLIN . CA 94568 <br /> ..r _ PHONE <br /> ( 510 ) 329-8= 91 <br /> CONTACT PERSON <br /> y DON,HOFFMAN <br /> SIGN URE.OF AUTHORI D AGENT / TITLE DATE <br /> /0Z 7/1, <br /> BASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> •r' ❑ 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 /> VACANT LOT <br /> '~ 835 W. CLOVER ROAD (209) 982- 1009 FAX <br /> TRACY, CA <br /> NAME . S Rr t <br /> „w, ... NOTE t TRUCK NUMBE <br /> MANLEY &: SONS TRUCKING . INC. <br /> ADDRESSJZ S 7 <br /> 8896 ELDER CREEK ROAD n <br /> .r CITY,STATE;ZIP; 0,1-6) 7/ <br /> SACRAMENTO CA 9582S <br /> PHONE _ 'F END DUMP BOTTOM;DUMF „w'TRANSFER <br /> .r �. ('916 ) 331-6864 ❑ ❑ <br /> SI RE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN_A - <br /> ,M �.t s <br /> - ❑ ❑ .. ... ❑ ❑ : <br /> r! <br /> FORWARD INC. LANDFILL cuBic.YARDsxu � Y <br /> 1.3 YARDS <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 DISPOSALMETHOD "(TO BE.COMPLETED BY•.`FORWAFDjy <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 �' OTHERS ' <br /> .r waste for any reason. If Forward's 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 /> ` EMARKS <br /> �r _R _.. ' ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> _ ❑ WOOD <br /> W. SIGNATURE OF AUTHORIZED AGENT DATE . <br /> f /. . ❑ 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 TRANSPORTER COPY MANIFEST # C 114 91 <br />