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WARD <br /> IVVIV—I—IHLHriUVUJ VVHJ I t IVIHIVIrC�71 <br /> tjjMrFr7 - WASTE TREATMENT AND DISPOSAL FACILITY <br /> A) JOB ACCEPTANCE N0. T�- CMnt `.:�4qq s - <br /> r- - F, <br />' GENERATOR --N'. _ _;�_, _; REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> WILLIAM STEWARD' []GLOVES ❑GOGGLES ❑RESPIRATOR E]HARE)HAT <br /> ILING ADDRESS - x- y rt w w 41 ❑TY-VEK ❑OTHER <br /> 452 W. L08ELL AVE. SPECIAL HANDLING PROCEDURES <br /> y- `aqc. <br /> CIGE <br /> STATE,ZIP -"'' . _ . _,- <br /> TRACY , <br /> �_ <br /> TRACY_ , CA 95367 L <br /> PHONE <br /> 209--835-5148 <br /> CONTACT PERSON <br /> WILLIAM STEWART <br /> SIGNATURE OF AUTHORIZED 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 /> '• <br /> Ej OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACIUTY (209) 982-4298 PHONE <br /> �IiII . 11 S T (209) 982- 1009 FAX <br /> TRACY , C 7 <br /> ME NOTES TRUCK NUMBER <br /> ADDRESS <br /> L E AVL :j r1 <br /> • CITY, STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> El <br /> SIGNATURE OF AUTI 6RIZED AGEIT OR DRIVER DATE ROLL-OFFS) FLAT'-BED VAN DRUMS <br /> El' ' ' 1 ❑ ❑ ❑ <br /> 71C ��-4CQ �• —ti—� /Jc 1 i�S <br /> _r <br /> FORWARD INC. LANDFILL CUBIC 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 FORWARD) <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 OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on 1 — <br /> weather or other site conditions Forward shall notify the Disposer when site <br /> conditions are expected to change such that Forward will be able to acc <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY/TICKET-NUMBER _ <br /> ff / ❑ WOOD <br /> SIGNATUF a� AUTHORI 'D AGENT / DATE <br /> ❑ ASH <br /> �` ✓�- L�� -z�--�—�+ L U `� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO,,4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL 0 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 MANIFEST # 27699 <br /> GENERATOR COPY <br />