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FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> ! N C O R P O R A TED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. -- d P17 <br /> GENERATQR C 0 X 4 REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> t, Z]GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 1 ,3- iGD Lia �f r'Z <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES _ <br /> PHONE <br /> CONTACT PERSON I-r�r _V @ c.-/,tJS <br /> LI)P-16NT i5�1v1FoA)HFA- T—,r c _5'E7F-V<F5 r,�c <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> WASTE TYPE 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 /> /114 v � f � �� (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> ADDRESS <br /> -. CITY, STATE, ZIP --T C <br /> PHONE l END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ s L*J <br />` SIGNATURE OF ALIT i ©RIZ7 AGENT OR DRIVER DATE ROLL-OFF{S) FLAT-BED VAN DRUMS <br /> El El <br /> nrl <br /> i El El <br /> 00RWARD 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$Y FORWgRb <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 ❑ <br /> s SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBER ❑ ASBESTOS <br /> ❑ WOOD <br /> SIGNATUJRE Q"UTHO_ ZED AG NT DATE <br /> _ ❑ ASH � <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • 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 CALL (209)982_4298 <br /> GENERATOR COPY MANIFEST # 67997 <br />