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FORWARD NON—HAZARDOUS WASTE MANIFEST <br /> �+b INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. I -- �` `7 <br /> GENERATOR _ [ r; 1C a _ REQUIRED PERSONAL. PROTECTIVE EQUIPMENT <br /> GLOVES ❑GOGGLES El RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> - PHONE <br /> CONTACT PERSON ?�, 9_ _ <br /> � �^ f? i -.f!✓ I y's�-�,^ S>.t �-�f��"� `'7 .��La" rr <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE9�1 <br /> N jj l trf F 's / <br /> WASTE YPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ® DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> i ` f, ✓ (209) 982- 1009 FAX <br /> 47<- <br /> 'el <br /> NAME "" NOTES <br /> TRUCK NUMBER <br /> c <br /> ADDRESS <br /> CITY,STATE,ZIP CA-. �1� 70 q <br /> RHONE END DUMP BOTTOM DUMP TRANSFER <br /> El El SE <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE r ROLL-OFF(8) FLAT-BED VAN DRUMS <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 Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site ❑ SOIL <br /> • conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • REMARKS ��� <br /> ' ❑ NON-FRIABLE <br /> � ) <br /> FACILITY TICKET NUMBER ASBESTOS r � <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGED DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL o 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 CALF. (209) 982-4298 <br /> MANIFEST# 67992 <br />