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WARD. INUIN-r1A4.AhL)UU0 VVNJ I G f <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. Li <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> WILLIAM STEWART []GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ILING ADDRESS _ ,f~ 5: ----_,._,� >„_ Y _ ❑TY-VEK ❑OTHER <br /> X452 Oil. LOWEEL AVE . x <br /> SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,bP <br /> TRACY, C4, 95367 <br /> PHONE: <br /> 209-835-5148 <br /> CONTACT PERSON -' 4{ `- r <br /> WILLIAM STEWART - SrJCK40)L <br /> SIGNATURE OF AUTHORIZED AGENT I TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL E] NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> `• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982--4298 PHONE <br /> :)1' 111TH S (209) 982-1009 FAX <br /> T_,'A c Y , IC A <br /> ME NOTES TRUCK NUMBER <br /> n; U,,'IIL j Oh. TIRUt:'<IiiNiG <br /> ADDRESS <br /> 1JJE `'"iJLT Jt � , �_ L0,A0 T1� <br /> • CITY STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT 0,R-DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> I / ; ❑ ❑ ❑ ❑ <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 <br /> weather or other site conditions Forward shall notify the Disposer when site ❑ S f <br /> conditions are expected to change such that Forward will be able to acce <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> _ NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMSER J' � <br /> I �i ❑ WOOD <br /> SIGNATUgE O AUTH0#:; D AdENT _ �r DATE ASH <br /> ! i r r' E) <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 />�T0 SCHEDULE CALL (209) 982-4298 5425 <br /> GENERATOR COPY MANIFEST # C <br />