Laserfiche WebLink
WARIV <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> JIAWIC., ,,<L. <br /> JOB ACCEPTANCE N0. (T} - CMK-- '4061 , { <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> }.WILLIAM._ STEWART _ = [3GLOVES []GOGGLES ED RESPIRATOR ❑HARD HAT <br /> ILING ADDRESSKt ' 4" ❑TY-VEK ❑OTHER <br />' 452 W. L O W E L L_ AVE. _ Y SPECIAL HANDLING PROCEDURES <br /> TEE, <br /> CITY.STA ZIE? <br /> • <br /> TRACY ,_CA 95367 _ <br /> PHONE <br />' 209-835-5148 <br /> CONTACT PERSON <br /> WILLIAM STEWART � m <br /> SIGNATURE OF AUTHORIZED AGENT ra/TITLE DATE } V,�6,9 1 L <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 /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br />' GENERATING FACILITY (209) 982-4298 PHONE <br /> 1'T r4 ` ' (209) 982-- 1009 FAX <br /> NAME NOTES I TRUCK NUMBER <br /> TC I TR : I.� <br /> DRESS <br /> 312 <br /> . CITY,STATE ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNAT4RE O ORIZED AGENT OR DRIVER DATE ROLL--OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> ff .� <br /> Forward shall have no obligation to accept the waste If weather Or other 1 <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 +s based on ❑ 501E <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 <br /> SLUDGE <br /> REMARKSo❑ <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> ' I I ❑ OTHERI - L <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 DELEVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY 136FORE <br />,TO SCHEDULE CALL (209) 982-4298 MANIFEST * C 5444 <br /> GENERATOR COPY <br />