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WARD - . NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC_ JOB ACCEPTANCE NO. S H - � r <br /> 14 <br /> GENERAT4,W ._ - REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MAILING ADDRESS l~� � I_ � r� �� � - - - <br /> [-]GLOVES <br /> TYo EK ❑OORESPIRATOR ❑HARD HAT <br /> HER ES ❑RE <br /> 1 L t C K '` f <br /> CITY,STATE,ZIP --, SPECIAL HANDLING PROCEDURES <br /> a_ . <br /> x� LC t.j f eft t ; tii�U _ <br /> - PHONE <br /> CONTACT PERSON <br /> SIG T URE OF_NLITHORIZED AGENT/TITLE DATE <br /> WA 91 <br /> TYPE_ T �. RECEIVING FACILITY �_--- <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982-1009 FAX <br /> �f A L.C) l �_-A <br /> NAME ^ _a NOTES - _ TRUCK NUMBER <br /> ADDRESS _ <br /> LLL\ <br /> • CITY,MTE,ZIP - _ ,_ _ <br /> ......_..L11tjT ` ��A ---PHONE END DUMP BOTTOM DUMP - TRANSFER - <br /> / Y i_2 1 - � ❑ 0 <br /> SIGNATURE OF AUTHORIZED AG ,, ©R DRIVER� DATE - ROLL-OFF- Sj_'�� FLAT-BED- _ VAN_ r DRUMS <br /> FORWARD INC. LANDFILL <br /> 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 11 - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the D_ISPO_SE BIO a AERATESiOCKPU OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on L <br /> weather or other site conditions,Forward shall notify the Disposer when site [ I <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS - _ �`-- -. <br /> • - '"""""�`"" � ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBERv <br /> —' ❑ WOOD <br /> SCE!VN}TURE OF AUTHORIZED AGENT _ DATE__�� <br /> { _ _ - ❑ ASH <br /> t � <br /> • •-_ s t - 1'y 1`f ❑ 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 MANIFEST# 14399 <br /> SALES COPY <br />