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(tijy)� t UKVVAK jJ _ NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED t WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. <br /> GENE_RATO_R.;'_jL-i:,.� <br /> GLOVES <br /> + ❑ " <br /> ^~ � ❑ []GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDF3�SS k` _ - �:��_" ; a ="'- ' �s ;�y ❑TY-VEK ❑OTHER <br /> ..;a_.c`�ax ''s - <br /> CIY, SPECIAL HANDLING PROCEDURES <br /> • f i1 S S r- r ,`-� �� I <br /> PHONE <br /> . c *,.y n." \i� - _�cr ... .C,_-'_ tee" - -. ir_ r a ���`✓y <br /> CONTACT PERSON - T v � r-�, _ _ t ;- ��•� <br /> SIGNATURE OF�f1UTFiORIZED AGENT I,TITLE_ ;z , DAT_E <br /> WASTE TYPE RECE�MNGrFACILff1F <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACIUTY-:, (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME ` <br /> • N t .i SLA L=�krL�»�s <br /> ! <br /> • / 4 f t - <br /> PHONE`�, , x' - r_ u `' .: r :t om P <br /> crs....,_ r❑ Ms <br /> SIGNATURE OF,4UTHORI7AD AGENT,OR DRNlwl� DATE ,i,4s ROE. -EF(S��,�� FL�4T BED VAN rx DR[ <br /> 1:1 El <br /> FORWARD INC. LANDFILL CUBICYARP§ <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 0 the waste SAL METHOD DISPOSAL '(TO BE COMPLETED BY FO <br /> impairs the safe and effective operation of the Landfill Forward shall use D SPO_ <br /> reasonable efforts to promptly notify Disposer of its inability to accept the __ 2 x w; � ; DISPOSE BIO AERATE - <br /> waste for any reason It Forward's refusal to accept the waste is based on " Y f J <br /> weather or otner site conadions,Forward shad 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 /> ❑ NON-FRIABLE <br /> FACILITY TICKETU M80 ASBESTOS <br /> JNf <br /> __ aaA ❑ <br /> WOOD <br /> SIGNATURE OF AU iORlZED AGgff1�-Z._ , ,, DATE <br /> ❑ 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 <br /> . . _ MANIFEST +Ir <br /> —_ _GENERATOR COPY -,� <br />