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TREATMENT AND DISPOSAL FACILITY <br /> rte' JOB ACCEPTANC646.' 1 CT unm— yoCl " <br /> GENERATOR,� REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />' alil lam S�e4��'•f _^- -- �- _ []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MNG.ADDRESS - n _ _ _ „ , _�. ❑TY-VEK ❑OTHER <br /> qS,Z (,(�' 1_,wet �WlG, _ ,-- . - - SPECIAL HANDLING PROCEDURES <br />' CITY,STATE,ZIP <br /> PHONE - <br />' ' 209 g3S--S/4/8 _ v <br /> CONTACT PERSON f z <br /> WI III fn <br />' SIGNATUR OF AUTHORIZED AGENT/TITLE DATE <br /> �c � <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 /> 1 - <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> Si; LtI �i %� si (209) 982- 1009 FAX <br /> «vy <br /> NAME NOTES TRUCK NUMBER <br /> DRESS <br /> • CITY, STATE ZIP Q {� <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> r/SZ — C///V �3 ❑ ❑ <br />' SIGNATURE OF AUTHORIZED AGENT DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> El El El <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 DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its mabdsty to accept the <br /> waste for any reascn If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site,- <br /> conddions 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 /> ._} ^ �` ❑ WOOD <br /> SIGNAT60_,QF AUTH9�IZED AftNT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 P M THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL OdLPOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209) 982-4298GENERATOR COPY5473 <br /> MANIFEST # C <br />' - - -- -- - - -- - - - -- -- -_._. —.. � —�__ � —_ ..� -- �... — � - -- - - -- <br />