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1rW 11•11 cv. <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> 9" WAR01- <br /> X' JOB ACCEPTANCE N0. <br />' GENERATOR _ _ '" -= ' ±` REQUIRED PERSONAL PROTECTIVE EQUIPMENT❑ [:]GOGGLES STEWART _ GLOVES GOGGLES RESPIRATOR ❑HARD HAT <br /> IU G'-ADDRESS _ ❑TY-VEK []OTHER <br /> 452 W ; LOWELL AVE. <br />' SPECIAL HANDLING PROCEDURES <br /> CITY,STATE_ZIP <br /> TRACY, CA 95387~ r <br /> -,� ------max <br /> 209-835-5148 <br /> CONTACT PERSON -- _ z <br /> WILLIAM STEWART ► <br /> SIGNATURE OF AUTHORIZED AGENT/TM-E DATE GV <br /> 9 1 STD <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 /> © OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY (209) 982-4298 PHONE <br /> i- 1 11 r 3'T (209) 982- 1009 FAX <br /> T ,PCY , C <br /> NAME NOTES - TRUCK NUMBER <br /> r _C t-ri 1T i �r1'; T"2 LI qtr ,v �✓!' •- <br /> DRESS <br /> . CITY, STATE ZIP <br /> IJ <br /> • PHONE END DUMP BOTTOM DUMP TRANSFER <br /> JLj ❑ ❑ ❑ <br /> SIGNATIJff OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> C3 11 <br /> * ice/ <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 d=soosal 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 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 <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS NON-FRIABLE <br /> ❑ <br /> ASBESTOS <br /> FACILITY TICKET NUMBER r ❑ WOOD <br /> RE f�F A&HORIZED/AGeNT _ DATE <br /> SIGI�ATU <br /> ' / p ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIORS 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 5458 <br />' GENERATOR COPY — - <br />