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FORWARD NON-HAZARDOUS WASTE MANIFEST �►�' INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY r JOB ACCEPTANCE NO. - �6? 7 GENERATOR © y� t a }C REQUIRED PERSONAL PROTECTIVE EQUIPMENT C Lu ❑GLOVES [:]GOGGLES ❑RESPIRATOR [-]HARD HAT MAILING ADDRESS ❑TY-VEK [-]OTHER 15-? -5 � � l��i SPECIAL HANDLING PROCEDURES CITY,STATE, ZIP �t -� PHONE � { , ��r��<•, 7 CONTACT PERSON 1,01-161-17 "r k1le es SIGNAT RE OF AUTHORIZED AGENT / TITLE DATE WASTIPE TYPE RECEIVING FACILITY ❑ SLUDGE ■ ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL • DISPOSAL SOIL ❑ WOOD F1 CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ■■ ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE (209) 982- 1009 FAX u NOTES TRUCK NUMBER ADDRESS / I . CITY,STATE,ZIP i PHONE END DUMP BOTTOM DUMP TRANSFER ❑ ❑ SIGNA�AEF//AUTHARIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS f ❑ ❑ ❑ 0 FORWARD INC. LANDFILL CUBIC YARDS Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) impairs the safe and effective operation of the Landfill Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER waste for any reason If Forwards refusal to accept the waste is based on SOIL weather or other site conditions, Forward shall notify the Disposer when site " conditions are expected to change such that Forward will be able to accept the waste ❑ SLUDGE • REMARKS ❑ NON-FRIABLE FACILITY TICKET NUMBER ASBESTOS ❑ WOOD SIGNATURE OF AUTHORIZED AGENT DATE ❑ ASH i ❑ OTHER i SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL (209)982-4298 MANIFEST# 6798A GENERATiaR COPY