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_ , ,. ���� ,' NON-HAZ!"'DOUS WASTE MANIFEST <br /> r..� WASTE T-R*MENT AND DISPOSALFACILITY <br /> INLr• JOB ACCEPTANCE NO. — t?bct3 � j <br /> GENERATOR �,.. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> "'r`I F--t— ! GLOVES [:]GOGGLES ❑RESPIRATOR E]HARD HAT <br /> MAILING ADDRES ❑TY-VEK ❑OTHER <br /> c ;` SPECIAL HANDLING PROCEDURES: <br /> ' . <br /> CITY,STATE, IP <br /> • P�. CAPNEi <br /> kl;T�5) WCE <br /> HRE <br /> YA <br /> SIG TOFAUTHORIZED AGENT/TITLE DATE <br /> -At:3-V k1ld <br /> WA TYPE t,- I t j 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_ - MANT€CA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> D (209) 982- 1009 FAX <br /> NAME NOTES: - TRUCK NUMBER <br /> ADDRUrT <br /> . CITY,STATE,ZIP '• '�� 7 C/ <br /> . � '. <br /> . PHONE �. � END DUMP BOTTOM DUMP TRANSFER <br /> . SIGCTURE�F�WORIZ D AGENT RIVER DATE ROL`?3FF(S) FLAT-BED VAN DRUMS <br /> / ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc 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-t4*_,wasE(_ --DISFSOSAL 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 BIO AERATE �jOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on 2 �� V V <br /> weather or other site conditions, Forward shall notify the Disposer when site ❑`SOIL 7 <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE 33 <br /> q i <br /> • REMARKS - <br /> ❑ NON-FRIABLE <br /> ASBESTOS / 2r <br /> FACILITY TICKET NUMBER <br /> -- ❑ WOOD <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 • 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 <br /> SALES COPY MANIFEST # 43313 <br />