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FORWARD NION-HAZARDOUS WASTE MANIFEST <br /> �►� I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ❑GLOVES ❑GOGGLES ❑RESPIRATOR E:1 HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> Dvz SPECIAL HANDLIN PROCEDURES r-1CITY,STATE, ZIP <br /> • PHONE �1-7 � ��€�« <br /> 3�9� �e N -- 1-f% 77 ,4 /2- D `1 <br /> CONTACT PERSON l�4f�lre� J:1 <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> ;P M <br /> WASTE PE RECEIVING FACILITY <br /> SLUDGE <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> E] CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> ('r '< -1 K <br /> r_- + I f1f�� J T 7�v�,� (209) 982- 1009 FAX <br /> NAME { f /y / NOTES TRUCK NUMBER <br /> ADDRESS , <br /> • CITY, STATE, ZIP <br /> PHONE --7 END DUMP BOTTOM DUMP TRANSFER <br /> i�/' I El 1-1 � <br /> SIGNATtd�jE`�FoAIJTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) 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 <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 is based on ❑ SOIL <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 EISLUDGE <br /> REMARKS <br /> • ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY 13EFORE <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST # 67982 <br /> f'r. r Yh 1.Tl1ll/l111\l <br />