Laserfiche WebLink
WANDWASTE TREATMENT AND DISPOSAL nr",T. <br /> JOB ACCEPTANCE N0. (T) CMM— 4061 <br /> -� �- REQUIRED PERSONAL PRO'T'ECTIVE EQUIPMENT <br /> GENERATOR T_ l. "�. :, _ ; :�-Y.. > Y <br /> WILLIAM STEWART �,.�,�� . _,— E ,�-.,,� [:]GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ILING ADDRESS s` Y _u _ ❑TY VEK [7]OTHER <br /> 452 W L O W E L L AVE . 4177 . SPECIAL HANDLING PROCEDURES <br /> CITY, <br /> • ZRACYN . CA— 95387n •� �b <_ , <br /> PHONE rr i.• JxMr - . z_.sem z _ ter..r -. -. <br /> 209-835-5148 <br /> CONTACT PERSON <br /> NILLIAM STEWART &rT-0GjCSIGNATURE OF AUTHORIZED AGENT!TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> F1TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> p OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 5 ,A ml ' `'€ ' (209) 982-- 1009 FAX <br /> A <br /> NAME NOTES — TRUCK NUMBER <br /> / N <br /> �T�,I ll�t rL I ail I ?1�0'CI 1 L7 (J1 <br /> RESS ` <br /> ;, r ik/ - <br /> ? .a� l L Ilk/ - <br /> , <br /> CITY, STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <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 DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <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 ❑ Ste-` <br /> conditions are expected to change such that Forward will be able to accept— <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ wooD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> --� I ❑ ASH <br /> k ri , 57 -1 Fi/ ❑ OTHER <br /> CHEDULING MUST BE MADE PRIOR-TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> UBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL,THE DAY BEFORE <br /> TO SCHEDULE CALL(209) 982-4298 • MANIFEST # C 5435 <br /> t - -- — - -- -- _._. -- - -_.....- - r''1=NERATORCOPY - -- -- - - -- -- - ---- - - <br />