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L �� T <br /> FORWARD NON-HAZP-)OUS WASTE MANIFEST <br /> INCORPORATED WASTE TREAI MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE No. <br /> GENERATOR <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> E4GLOVES ❑GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING ADDRESS V <br /> ;k _ _ CaTY-VEK ❑OTHER <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> r _ <br /> •) : ..��� ������,�' •'-1 -!� r.y J- moi.+.r'�r <br /> PRONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTO R ZED AGEN€ / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> • ❑ SLUDGE <br /> — ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> I ' aDISPOSAL SOIL ❑ WOOD <br /> T❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> s• <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> �20-/9; 2- 1 :X9 FAX t <br /> NAME <br /> s E <br /> TRUCK <br /> NUMBER" <br /> CITY_,.STATE;Z€P' <br /> CPHO E 3w END DUMP BOTTOM0UMP TRANSFER <br /> SIgNATURE-6�AUTHORIZED'AGENT'OR DRIVER., DATE ROLL-OFFS) FLAT-BED VAN DRUMS m <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 'Haste 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 BIQ AERATE STOGKPIL.E OTHER <br /> waste for any reason. if Forward's refusal to accept the waste is based on <br /> t 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 /> a REMARKS <br /> ❑ NCN-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> WO <br /> OD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> "OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> .U3jECT TORE'FUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST' BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> -0 3CHEDULZ ALL 5209) 982-4298 i :1;y ,_--7 n yy <br />• - - - - - ....,.-,...,..,,,-_. -- --- ——- MANIFEST # <br />