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FORWANON-HP'- 1RDOUS WASTE MANIFEST <br /> o. _ <br /> C <br /> 1 N ;- ) R T <br /> L O R A L D WASTE TATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. - 4638 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMT <br /> mss. SPE I NC [-]GLOVES ❑GOGGLES [-]RESPIRATOR.-.-- ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 11828 DUBLIN BLVD. <br /> ATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> CITY;Si <br /> • DUBLIN, CA 94568 <br /> PHONE <br /> ( 510 ) 829-8491 <br /> CONTACT PERSON <br /> DON^HOFFMAN <br /> '• ' SIT-URE OF AU THORIZ ENT /TITLE DATE <br /> ,.. WASTE TYPE q RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY <br /> VACANT LOT 1/209) 982-4298 PHONE <br /> s35 �V- CLOVER ROAD (209) 982- 1009 FAX <br /> TRACY, CA <br /> J <br /> NAME NOTES: TRUCK°NUMBERa <br /> _. <br /> MANLEY & SONS TRUCKING , INC. � <br /> ADDRESS <br /> 8896 ELDER CREEK ROAD <br /> . CITY,STATE,ZIP <br /> SACRAMENTO, CA 95828 <br /> PHONE END DUMP BOTTOM DUMP, TRANSFER <br /> ( 916 ) 381-6864 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER_ DATE ROLL-OFFS) FLAT-BED rv.:r: VAN, x DRUMS=` <br /> El El El El . <br /> FORWARD INC. LANDFILL Cualc YARDS _ w* <br /> 1S 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 DISPOSAL METHOD:' (TO BE COMPLETED BY OR <br /> FWARD <br /> impairs the safe and effective operation of the Landfill. Forward shall use } "-.k � ) <br /> reasonable efforts to promptly notify Disposer of its inability to accept t DISPOSE --BIO AERATE STOCKPILE r OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based n <br /> i <br /> weather or other site conditions,Forward shall notify the Disposer when site A5�71L <br /> • conditions are expected to change such that Forward will be able to acpep� , <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY"TI Kt`T MUM ER <br /> SIGN U / ❑ WOOD <br /> R <br /> AUTHORIZE 'AGENT . DATE j <br /> ! _ ❑ ASH <br /> G <br /> 1 -�/ i ❑ 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. �NGOING D ILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE: <br /> TO SCHEDULE CALL (209)982-4298 <br /> -0 TRANSPORTER COPY MANIFEST # C1`1 4 8 7 <br /> �, <br />