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FORWARD NON-HAZARDOUS WASTE MANIFEST INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT M 'yw' �� ;❑GLOVES [_I GOGGLES El RESPIRATOR [:]HARD HAT MAILING ADDRESS ❑TY-VEK ❑OTHER CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES r} PHONE - CONTACT PERSON SIGNATURE OF AUTHORIZED AGENT / TITLE DATE WASTE TYPE RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL, [:❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • E� DISPOSAL SOIL ❑ WOOD ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE (209) 982- 1009 FAX s ^ meq- ` C / . A I .✓ f NAME I �f NOTES f TRUC NUMBER ADDRESS r' r CITY, STATE, ZIP PHONE END DUMP BOTTOM DUMP TRANSFER SIGN #UTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS El E3 1:1 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 (TQ BE COMPLETED BY FORWgRD 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 weather or other site conditions, Forward shall notify the Disposer when site ❑ SOIL • conditions are expected to change such that Forward will be able to accept the waste ❑ SLUDGE REMARKS ❑ NON-FRIABLE FACILITY TICKET NUMAE11 ASBESTOS ❑ WOOD SIGNOURE OF lTfHORIZED AGENT f' DATE _ .�� ❑ ASH i ❑ OTHER SCF#EDIJLING 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 # 67990