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Tr ; )-;+ORWART -�" ti NON-HAZ/''D06S WASTE MANIFEST <br /> �� I N C O R P O R A T E [i WASTCTRE'nr MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REILIIRED PERSONAL PROTECTIVE EQUIPMENT <br /> �t7� `� ❑i"aLOVES ❑GOGGLES [:]RESPIRATOR ARD HAT <br /> MAILING ADDRESS_ - �` '�� ❑TY-VEK ❑OTHER <br /> IT � <br /> CITY, STATE,ZIP � �� �� � SPECIAL HANDLING PROCEDURES <br /> - -PHONE _ <br /> CONTACT PERSON _ <br /> Via'�►1�. <br /> SIGNATURE 6F AU_THORIZED AGENT / TITLE DATE <br /> ■ WASTE,TYPE RECEIVING FACILITY <br /> ❑ SLUDGE k <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • W,DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> OTHER � <br /> • MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY _ _ (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> DAME _ NOTES <br /> �_W -_ ) ; Y'C r_ __ —_. _-. _._.. _ _ _ �_ _ _ TRUCK NUMBER <br /> ADDRESS <br /> . _CITY_, STATE,ZIP k1716 <br /> PHONE _ _ ry TA� END DUMP BOTTOM DUMP_ TRANSFER) <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER-' DATE _ _ ROLL-OFF(S)- FLAT-gEp VAN- µ DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS v <br /> Forward shall have no obligation to accept the waste if weather or other 'f <br /> conditions impair the safe and effective disposal of the waste or if1the waste DISPOSAL METHOD (TO BE COMPLETED BY FOR <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 Forwards 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 I <br /> the waste ❑ SLUDGE <br /> • REMARKS <br /> - - ❑ ICON-FRIABLE ! <br /> FACILITY TICKET NUMBER - ASBESTOS <br /> _ <br /> El WOOD � <br /> » SIG_NATURE OF AUTHORIZED AGENT �w-- DATE <br /> ' - *- ❑ ASH <br /> `�"' ❑ OTHER ' <br /> F <br /> SCHEDULING MUST BE MADE FV 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVALONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4298 <br /> MANIFEST # 106298 <br /> SALES COPY <br />