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ARDWASTE TREATMENT AND DISP�AL FACILITY <br />' IrC� JOB ACCEPTANCE N0. o. !SG <br />' GENERATOR =j - REQUIRED PERSONAL FROTECTNE EQUIPMENT <br /> WILLIAM.. STEWART, _, _ r� .• y ❑GLOVES []GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> ILING'ADDRESS — „ v ,, �I- �� ;�; ��;_ ; ❑TY-VEK []OTHER <br /> 452 W. }L 0 W L L -AVE. SPECIAL HANDLING PROCEDURES <br /> CITY.STATE,ZIP <br /> • _ TRACY 11,- CA 95367 ,_ <br /> PHONE <br /> 209-835-5148 <br /> CONTACT'-PERSON- <br /> WILLIAM <br /> ONTACTPERSON-WILLIAM STEWART GIC L <br /> 1 SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE <br />' WASTE TYPE RECEIVING FACILITY <br /> ❑ <br /> SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br />' - ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> F1 CONSTRUCTION SOIL ❑ ASH ASH <br /> p OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> i1 i'i 5T <br /> (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> DRESS <br /> ' llLi f; ill = . �. �� ; ". <br /> CITY STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> El <br /> SIGNATURE OF AUTHORIZED AGE OR DRIVER DATE ROLL-OFFS) FLAT-SED VAN DRUMS <br /> 11 D El 13 <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 it 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 SPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on �rn�SOIL 4i1 <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 accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNA76RE OF AUTHORIZED AGENT DATE <br /> f ❑ ASH <br /> ❑ OTHER <br /> In I <br /> CHEDULING 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 /> I O SCHEDULE CALL (209) 982-4298 MANIFEST * C 5441 <br /> GENERATOR COPY <br />