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t `t� FORWARDNON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INCORPORATED <br /> JOB ACCEPTANCE NO. -745711'_- , <br /> ' ENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MP Pdrely= ®GLOVES [:]GOGGLES ❑RESPIRATOR Q HARD HAT <br /> MAILING ADDRESS []TY-VEK []OTHER <br /> 2191 Navy rive <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> StodldiorCA 95206 <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ wool) 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> ME TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS TRAILER LIC <br /> • CITY,STATE,ZIP TRAILER LIC # <br /> _1T__CA:3;T 4 <br /> PHONEEND DBOTTOM DUMP TRAN <br /> f! SFER <br /> El 1:1 Cl <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-SED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> i <br /> FORWARD INC. LANDFILL cuelC YARDS <br /> Forward shelf have no obiication to accept ,he wane if weather or other � <br /> conditions impar the safe and eifective disposal of the x%asie or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and etfectrve operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inabdity to accept the l DISPOSE 810 AERATE STOCK?LtE OTHER <br /> wasie for any reason If Forv.ard s refusal it) accept the waste is based on ©SOIL <br /> weather or other site conditions,Forward shall notdy the Disposer when site <br /> conditions are expected to change such that Forward will be able to accept' <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON FRIABLE <br /> _ <br /> FACILITY TICKET NUMBER � ASBESTOS <br /> ❑ WOOD <br /> SIGNATUR O AUTHORIZED AGENT DA E <br /> � ❑ ASH <br /> ;1`#, 1� 0� M OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> �BJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SCHEDULE CALL(209) 982-4298 r� <br /> 011G9571NHy6 P6 GENERATOR COPY MANIFEST # C G <br />