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S ARD- NON-HAZARDOUS WASTE MANIFEST WASTE TREATMENT AND DISPOSAL FACILITY AfAX11 JOB ACCEPTANCE N0. GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT _ Y- w j�- f_ ❑GLOVES E]GOGGLES ❑RESPIRATOR ❑HARDf HAT MAILI G ADDREX r L ❑TY VEK [:]OTHER - CITY, tATE f - SPECIAL HANDLING PROCEDURES Sf ,`Z,IP i� J_ 4. _"c- 20- PHONE - - CONTACTPERSON_ SIGNATURE OF AUTHORIZED AGIO{T/Ti_TL_E'„ DATE totM1. W E TYPE - RECEIVING FACILITY_ 'T ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL • DISPOSAL SOIL El WOOD ONSTRUCTION SOIL ASH 9999 SOUTH AUSTIN ROAD ❑ ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATIN3FACILITY _ - (209) 982-4298 PHONE I`- Z- (209) 982- 1009 FAX NAME - NOTES: TRUCK NUMBER -36 ADDRESS CITY STATE ZIP - PHO ___cti1 �....�.� NE K, r` A END DUMP- L-BOTTOM QUMP_ TRANSFER_ r El . SIGNATURE OF AUTHORIZED-AGENT OR F)RIVER DATE _ =ROLL-0BED VAN-- " rDRUM 0 El FORWARD INC. LANDFILL CUBIC YARDS�,-_ Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (T E COMPLETED BY�FOIINARD) impairs the safe and effective operation of the Landfill Forward shall use - a , reasonable efforts to promptly notify Disposer of its inability to accept the S_POSE BIO' AERATE IS7 CIPHER"; waste for any reason If Forward's refusal to accept the waste is based on weather or other site conditions,Forward shall notify the Disposer when site JWSOIL ' conditions are expected to change such that Forward will be able to accept the waste ❑ SLUDGE REMARKS i ' ❑ NON-FRIABLE FACIUTY-PICKET NUMBER - ASBE570S y ❑ WOOD SIGNATEIRE OF AUTHORIZED AGENT � ' - DATE _ ❑ ASH � r �� ; ' - ' �` ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL (209)982-4298 MANIFEST # 14393 __SALES COPY