Laserfiche WebLink
pmmnal WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO, (Ty eMM7 anei �;"��; •�;; 3�vsaL, los. <br /> GENERATOR - REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> WILLIAM STEWART_ _ _ ❑GLO-VES ❑GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> ILING ADDRESS ,�;' � �-M.rte u ❑TY-VEK []OTHER <br /> 452 W . IOWELL AVE . <br /> CIMSTATE;ZIP -w_. 1,4,`�ti SPECIAL HANDLING PROCEDURES <br /> TRACY, CA -98367 _ <br /> PHONE <br /> 209-835-5148 <br /> I CONTACT PERSON <br /> WILLIAM STEWART ,L]_ <br /> SIGNATURE OF AUTHORIZED AGENT f TITLE _ DATEL'1� )I L. E <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> l <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> I • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> �T <br /> „v„ , �;, (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> tJrs �aT03N TRUCC�iIf� ;- /�l <br /> DRESS V <br /> 11�C, J ,, , T, r- aV —32 <br /> . CITY, STATE ZIP <br /> I PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED ��ENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS }} <br /> Forward shall have no obligation to accept the waste if weather or other t <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 810 AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on 1� <br /> weather or other site conadions Forward shall notify the Disposer when site EZSOIL <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 /> 11 ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> �� ❑ ASH <br /> \� f C� ❑ 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 /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # C 5446 <br /> GENERATOR COPY <br />