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FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED b WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. 31'Y=„ ;; , <br /> GENERATOR REQUIRED PERSONAL PROTECTNE EQUIPMENT <br /> IRP Petrolim m _ FL]GLOVES [:]GOGGLES ❑RESPIRATOR HARD HAT <br /> ' MAILING ADDRESS TY-VEK ❑OTHER <br /> 21191 Nny Dinve <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> 9t0d3C-4C 4 9!206 <br /> ' - PHONE <br /> CONTACT PERSON <br /> SiGNATLIPE O AUTHORIZED,AGENT/TITLE DATE <br /> ��- <br /> • WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 9321,.4:r S-'Yd '`AN7 A (209) 982- 1009 FAX <br /> rF TRACTORLIC, TRICK NUMBER_ <br /> :U;��tg <br /> ADDRESS TRAILER LIC ✓ � J <br /> 'r t C'f,�Sox 51-9 <br /> • CITY,STATE,ZIP TRAILER LIC # <br /> CA 92414 <br /> PHONE END ,UMP BOTTOM DUMP TRANSFER Z <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE g ROLL-OFFS) FLAT-BED VAN DRUMS <br /> El El El 13 <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obliQailon to accept the waste if weather or other 1 �1 <br /> condrtions impair the safe and effective disposal of the waste or if the wastep15POSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shsil use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE 8l0 AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> 01L <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 - <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER - <br /> _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGEIJT - DATE,” =�_ <br /> t ❑ ASH <br /> 2 <br /> �n—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 foul58899q1 <br /> MANIFEST # C{Cp5t tNHt 6 46 GENERATOR COPY <br />