Laserfiche WebLink
WA HLI <br /> _ WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. (T) cMs=-=rosis: =x:- <br /> �rRs,' it...L <br />' GENERATORAr_ .y � ,., ,_„._f�,�.',g,_!, i` k ,___y REQUIRED,PERSONAC PROTECTNE EQUIPMENT <br /> WILLIAM STEWART _ ❑GLOVES []GOGGLES ❑RESPIRATOR []HARD HAT <br /> ILfNG ADDRESS «; "� ; "' "__ ATL ,r ❑TY-VEK ❑OTHER - <br /> 452 t W. LOWELL -AVE . ~_CITY STATE..ZII - " ,. _ „ �5� � ;� �M u_ _ r SPECIAL HANDLING PROCEDURES <br /> -TRACY , CA 93367 <br /> PHONE <br /> t209-835-5A149 <br /> CONTACTPERSON ti F) c. <br /> WILLIAim STE'�IART <br />' SIGNATURE OF AUTHORIZED AGENT!TITLE DATE <br /> �k Ag� `T t4 X-,?� 4-10-5 s <br />' WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br />' • ❑ DISPOSAL E] 9999 SOUTH AUSTIN ROAD <br /> ❑ <br /> CONSTRUCTION SOIL ❑ ASH ASH <br /> E3 OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 51 15 �A 1� ' `� ST , 209 982- 1009 FAX <br /> T.R IC'NAME NOTES TRUCK NUMBER <br /> 4 1,17L T'111 T�;U ,:T1I' <br /> DRESS L^',i C <br /> IL:.2r P,ajLI„E AVE <br /> CITY STATE ZIP <br /> I'”JrS i s , 5 3 <br /> a PHONE _ 7 END PUMP BOTTOM DUMP TRANSFER <br /> :121 ❑ ❑ <br /> SIGNATURE OF AU TH IZED AGEf1T OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ' ❑ ❑ ❑ ❑ <br /> 41, <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 :ts inability to accept the DISPOSE 810 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 Ltl SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> ` REMARKS <br /> Ei NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> -., ❑ WOOD <br /> SIGNATYRE,OF AUTHORIZED AGENT DATE <br /> f\ ❑ ASH <br /> ❑ OTHER <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 /> ITO SCHEDULE CALL (209) 982-4298 MANIFESTO C 5442 <br /> GENERATOR COPY <br />