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FC J _� NOWHAZ�' 70US STE MA <br /> NIFEST <br /> f ., .�. <br /> �► I N C O R-PO R A T E ❑ WASTE TREATMENT ANDUISPQSAL FACILITY" <br /> JOB ACCEPTANCE N0. ron_ `t <br /> GENERATOR REQUIRED PERSONAL_PROTECTIVE EQUIPMENT <br /> �~ U �? , iv. £C, V j 7-p,,�C {��� []GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> # N` ILING AD9RESS� ❑TY-VEK [:]OTHER <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> 47 <br /> HONE } <br /> ,{ 2 <br /> C.. <br /> ONfACT�ERSON ' <br /> S1G`IVA �JFiE OIIAUTt_iORj2ED AGENT,jATL,,,E DATE <br /> jr <br /> * WA$TE'TYPE RECEIVING FACILITY <br /> ❑ SLUDGE - <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC.'LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br />'; rr <br /> r_1 STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> t NAME ��-i mss;—s�-c Ty a.,-►-fxp) �6 c-y TRACTOR UC.# TRUCK NUMBER <br /> AAti <br /> ADDRESS a.c� s Y.;fo�{. 0d 4/4�i TRAILER LIC.:# �r)jq t� <br /> . CITY,STATE,ZIP e_411 Cr} 6, q T-- 92- TRAILER LIC.# , <br /> PHONE - �? - /�/a) END DUMP BOTTOM DUMP TRANSFER <br /> i ❑ ❑ ' <br /> . SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL,�,S) 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 /> k reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> 4 waste for any reason. If Forward's refusal to accept the waste is based on I—I <br /> weather of other site conditions,Forward shall notify the Disposer when site 1� IL <br /> conditions are expected to change such that Forward will be able to accept j <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> I ❑ NON-FRIABLE <br /> ASBESTOS ) <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE i <br /> ❑ ASH <br /> ❑ OTHER <br />. SCHEDULING MUST BE MADE PRT6R TO AZO P.M. THE DAY PRIOR TO EXPECTED ARRIVAL w 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 /> FO (C951INH)6-96 SALES COPY MANIFEST# C 705751 I <br />