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Jn-FORWARD' WAtTE TREATMENT AND DISPOSAL FACILITY <br /> A1C. JOB ACCEPTANCE N0. - ' 4 ���`_ <br /> (T) CMF4— 4C6 :- <br /> • y <br /> GENERATOR_,• .:� _ ? _. r ''` �.;��r= .' ►-- *_ �-�-- REQUIRED PERSONA.PROTECTIVE EQUIPMENT <br /> WILLIAM 9T E�,IA R.Tr_ _ - ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> '- �•� [:]TY-VEK ❑OTHER <br /> LUNG ADDRESS - _ ' <br /> -" - _.. -:.`'X_w... ?_.�. _..rte a•,,.��. .ice.-s.. <br /> 452 W. , L 0 W E LL A-V E ._ r- — -wr- SPECIAL HANDLING PROCEDURES <br /> CIT`4 STATE,ZIP <br /> • <br /> TRACY ,, CA 95 ,6_7 s <br /> PHONE <br /> 209-835-5148 _ <br /> CONTACT PERSONWILLIAM STEWART <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE O I Li 1 <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE FORWARD INC LANDFILL <br /> ` ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> .. ❑v OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> -� 11T 1 ; r . (209) 982- 1009 FAX <br /> ME NOTES TRUCK NUMBER <br /> DRESS `J <br /> r <br /> l <br /> = <br /> J ,: � � _ ! � � <br /> . CITY,STATE ZIP <br /> i tib'] 7 7 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> -) 1 ? -- 1 0 ❑ ElSIGNA PRE OF AUT RIZED AG�NT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ���f/%� �L}/�n 1� �} /r� f�x/7'1 ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS l <br /> Forward shalt 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 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 <br /> conddsons 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 7RC RET P46MLR� <br /> / /r / ❑ WOOD <br /> SIG�IATU E AYAUTJ40E ZEDIAGENT DATE// [:1 ASH <br /> f r� ,�. 'G ❑ OTHER <br /> CHEOULING MUST BE MADE PRIO9 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 GENERATOR COPY MANIFEST # C 5452 <br />