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NON-HAZARDOUS WASTE MANIFEST <br /> " <br /> wRD—­--ft WASTE TREATMENT AND DISPOSAL FACILITY <br /> I JOB ACCEPTANCE NO. s N i� 4j-714 <br /> GENERATOR _ _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> I t t-� .1) (:::�`�,`_L �� If I (�2_j' [:]GLOVES ❑GOGGLES [-]RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS _—7 ❑TY-VEK ❑OTHER <br /> -1 w `� SPECIAL HANDLING PROCEDURES <br /> CITY,STATE, ZIP - F <br /> - PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE _ DATE <br /> • E _ � - RECEIVING FACILITY_ _ <br /> ❑ SLUDGE �'L <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE�ASBIS OSI �! FORWARD INC. LANDFILL <br /> CONSTRUCTION SOIL <br /> • ® DISPOSAL SOIL [:19999 SOUTH AUSTIN ROAD <br /> ❑ ASH ASH �'�� �`"� <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHON <br /> (209) 982- 1009 FA5 -'P"�'7"� <br /> NAME _ NOTES _ �= _ -- _ -- --TRU K NUM_. S-ER. 2 <br /> ADDRESS! ,. <br /> P—tr�.e ' ,��L„ ��i�� �17 �, L._ '7�-°'+v` 1� r �'.- - r.-. _ ..... � _-, --• e �r""r�'_ <br /> f CITY <br /> t <br /> _ <br /> 'PHONE _ '- — EN©DUMP 'BOTTOMUUMP- TRANSFER <br /> -r 1, El 0 <br /> ,SIGNATURE OF}IUTI-IORIZED—AGENT OR DRIVER ^ DA4_TE . , ROLL F(S FLAT-BED - VAN , _ ©Fit3MS_ h. <br /> 4�- FORWARD INC. LANDFILL CUBIC =r- =bT �� <br /> c c YARDS tee_ <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the safe and effective disposal of�tew7,%rd <br /> d the waste DISPOSAL METHOD' (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of tt�+�fshall usereasonable efforts to prom t nota Dis ser of iiAaccept the ISPOSE a-'BIO t AERATE STOCKPILE" OTHERP IY fY Po .� s. <br /> waste for any reason If Forward s refusal to accept the waste is based on OIL <br /> weather or ther site conditions Forward shall notify the Disposer when site <br /> the was � e1exered to change rych that Forward vplt e pblp to accept <br /> the wase i '�l.J � ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ._. ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ~ 30��a- - ❑ WOOD <br /> SIGATURE OF AUTHOR AGI!!F� - DAA _ <br /> E] ASH ' <br /> �L� I l ❑ OTHER <br /> HEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> EJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SCHEDULE CALL(209)982-4298 MANIFEST# 14400 <br /> SALES COPY <br />