Laserfiche WebLink
� ���� WASTE <br /> TREATMENT <br /> DISPOSAL <br /> I <br /> � WASTE TREATMENT AND DISPOSAL FACILITY <br /> z ��+�" : JOB ACCEPTANCE N0. [f) 'CMH- <br /> 4c <br /> - ;zL4ost <br />' GENERATOR y _ ; , K_ _ _ _ _ - _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT _ <br /> WILLIAM STEWART ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ILINGADDRESS _ �; -` �,�, K;'^ ar! ,� v_ r ❑TYVEK ❑OTHER <br /> 452 W. L O W E L L AVE. _ t. _ T,_�_� -,� _._.i_ SPECIAL HANDLING PROCEDURES <br /> CITY STATE,ZIP %�- '� <br /> • TRACY, CA 95367 <br /> PHONE; <br /> 209-835-5148 <br /> CONTACT PERSON _ - r t `•` •� r_ ,,� ' _ ." " <br /> WILLIA+1 STEWART <br /> SIGNATURE OF AUTHlORf�ZE/D AGENT/TITLE"- DATE ' <br /> WASTE TYPE RECEIVING FACILITY <br /> ' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> • Q OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> i- i 1 1T,i a T• (209) 982- 1009 FAX <br /> ME NOTES TRUCK NUMBER <br /> v1C-I A„t;LTC J T;, C.<TI4 <br /> ADDRESS i <br /> 1. L1 t „'I <br /> • CITY STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHOR)ZED AGENT�D DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> - �- ❑ Cl ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other 1 <br /> conditions impair the safe and effective disposal of the waste or .f the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use j DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the f <br /> 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 s� <br /> conditions are expected to change such that Forward will be able to aecipt <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ <br /> FACILITY TICKI�T NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATORE,DF AUTHORIZEI/AGENT / DATE <br /> l-, ❑ ASH <br /> �_1.v�t--�� �,7� rl ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR.T,"00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVACONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # 2 7 6 9 6 <br /> GENERATOR COPY <br />