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w NON-HA7ARDOUS WASTE MANIFEST <br /> ■ ARD WASTE 1,, i4TMENT AND DISPOSAL FACILITY <br /> INC,.40 f JOB ACCEPTANCE N0. <br /> i.� GENE ^`OR, '?err » �t; „ �'sHi REGIUIRED,PEFiSONALROTECTIVE <br /> EQiJiPMENT_ r =, <br /> t 'e <br /> ❑GLOVES GOGGLES ❑RESPIRATOR []HARD HAI .l <br /> MAILING ADDRESS <br /> � h • '�. •".� ❑TY� <br /> VEK,^. [I OTHER ' <br /> _mss: box <br /> ■ CITY:S7ATE,ZIPm -:, " L SPECIAL HANDLING PROCEDURES: <br /> C. rNn..ie: ':_is:rxr' _;ykty <br /> CO cr- <br /> SO � j} NoAle <br /> . SIGNATURE OF:A' ORiZED AGENT% 11Tl E w' I]ATE_. <br /> i� ` FsYWASTE.TYPEEMN,GFACIT..S•nrsi, ,. <br /> j <br /> L ` ❑ TREATMENT SOIL ❑ NON SLUDGE <br /> ASBESTOS � FORWARD INC. LANDFILL <br /> Er <br /> • DISPOSAL SOIL ❑ WOOD } <br /> ❑ CONsTRucTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> L . ❑ OTHER . MANTECA, CALIFORNIA 95336 <br /> GENERATINGFACIpa,. <4 = � (209) 982-4298 PHONE <br /> = -t `a <br /> L ic, 6e I I <br /> (209) 982- 1009 FAX <br /> NAME _ <br /> ADDRESS-g� � ,. �Q <br /> �`r U I�.:e r f Ss d #' �2 Tr'L - FT 5 31I�1 ' <br /> • CiTY,,STATE,71P..� ,-�` �,' `� �` n•I.: , »� �' { , =�, .��, � R <br /> PHON ; y' = z a _ EN©DUMP, "x ` BOT70M DUMP . �M,TRANSFER <br />� ' • �(_�c7�� 7z cr -d oto <br /> 1nA r <br /> ...,IZED AG DATE r.' P1,-OFFS FLAT=BE� . <br /> SIG TURF AUTHORISED AGENT.OR.DRIVER- �. e . - _ .,f <br /> - - s�yo 0 0 0 <br /> FORWARD INC. LANDFILL cuSfcirDsr . r � "a � <br /> �,. <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 FORVV&4RD.) I <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 r SPOSE {=BIO=>�. �4ERATE <br /> L <br /> STOC!( ICE .:YTH <br /> waste for any reason. If Forward's refusal to accept the waste is based on i <br /> weather or other site conditions,Forward shall notify the Disposer when si <br /> ' conditions are expected to change such that Forward will be able ccept ,� <br /> the waste. E] SLUDGE <br /> REAIIARKSR =z � 'pi .1 <br /> ■ NON;FRUIBLE <br /> }_ ❑ ASBESTOS ;M <br /> ❑ WOOD <br /> SIGNA^ �EA O D ENT:. " r.c k <br /> ASHp <br /> ❑ OTHER <br />[ SCHEDULING MUST BE MADE PRIOR IT" P.M. THE DAY PRIOR TO EXPECTED(ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL-ONGOING DAILY DELIVERIES MUST BEISCHEDUL.ED WITH THE LANDFILL THE DAY BEFORE, <br /> TO SCHEDULE CALL (208)982-4298 MANIFEST# 3054 <br />