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FORWARDS NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED <br /> • A WASTE TREATMENT AND DISPOSAL FACILITY <br /> �p ��., <br /> s - <br /> JOB ACCEPTANCE N0. F745711- <br /> VENERATOR <br /> REOUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> petilaim ©GLOVES ❑GOGGLES ❑RESPIRATOR ®HARD HAT <br />' MAILING ADDRESS a ❑TY-VEK ❑OTHER <br /> 2141 Navy D.n,e <br /> SPECIAL HANDLING PROCEDURES <br /> CITY.STATE,ZIP <br /> : 3tock-tcaCA 95206 <br /> - PHONE <br /> CONTACT PERSON <br /> 1y <br /> SIGNATURE 0AUTHORIZED AGENT/TTLE DAT <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE FORWARD INC LANDFILL <br /> ` ❑ TREATMENT SOIL ❑ NON-FRIABLE ASSES70S <br /> • f71 DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> ' P3s MoFD-_t Em rCA- (209) 982- 1009 FAX <br /> ME TRACTOR LIC # ` TRUCK NUMBER <br /> �, , !� f <br /> • ? <br /> ADDRESS TRAILER LIC # <br /> �c•,l[rffize Box 519 <br /> CITY,STATE,ZIP TRAILER LIC # r <br /> 0y-c-r:C ti 93414 <br /> • PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (n2.;534-t03''4 ❑ Cl ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> f ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conoitions impar the sale and effective disposal of the waste or,f the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use DISPOSE BIO AERATE JSTOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason It Forv.ard s refusal to accept the waste is based on ❑ SOIL <br /> weather or other site conditions,Forward shall notify the Disposer when site <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • REMARKS NON-FRIABLE + <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER _ <br /> _ ❑ WOOD <br /> _ kGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> JCS jlZ �C <br /> El 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# C 6 88 S 7 8 <br /> F01 tC951INH)6 96 GENERATOR COPY <br />