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NON-HAZARDOUS WASTE MANIFEST <br /> FORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INCORPORATED <br /> - ,2, .w <br /> JOB ACCEPTANCE N0. � . - _ �< <br /> aENFIATOR.y ^i" `- _ ��____�__ = "' -_ _ -`. REQUIRED PEISONALPROTEG7lVE.EQUIPMEi+fT" <br /> M GLOVES 0 GOGGLES ❑RRESPIRATOR ®HARD HAT <br /> MAILING ADDRESS 3T _ 77 <br /> ❑TY-VEK ❑OTHER <br /> S21 Weat Poe$tom SPECIAL HANDLING PROCEDURES <br /> CITX,STATE,ZIF?_ - _ - <br />' - PHONE __—_ - L <br /> (209)943-2011 <br /> COC7`� <br /> SIGNA R OF UTH ED AG T/TITLE OATE <br />' WAS TYPE _ _ __ _ RECEIVING FACILITY <br />' ❑ SLUDGE FORWARD INC LANDFILL <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br /> • } 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 />' 444 hon 1e RtM LATIf ROP (2 0 9) 982- 1009 FAX <br />' NAME _k*T `A kj-4 ^ t TRACTOR LIC # �}C 1 O, 1(� TRUCK NUMBER, - <br /> ADDRESS TRAILER LIC # ✓6-!5.74 <br /> TRAILER LIC # <br /> CITY, STATE, ZIP d1 <br /> PHONE <br /> _END DUMP BOTTOM DUMP _TR_ANSFER <br /> ❑ ❑ ❑ <br /> . SIGNATURE OF AUTHORIZER AGENT OR DRIVER DATE ROLL-O&(S) FLATBED V� DRU❑MS <br /> FORWARD INC. LANDFILL CUBIC 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 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 STOCKPILE OTHER <br />' reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason If Forwards refusal to accept the waste is based on �J�ISEIL <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 T_ NON-FRIABLE <br /> ASBESTOS <br /> 1=ACILITY TICKET NUMBER <br />' -�- -- - -- � E] WOOD <br /> SIGNATUREEQF AUTHORIZED AGENT DATE <br /> - E] ASH <br /> / % ��/• ;%,/ ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR 4.00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAbj4doING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br />' TO SCHEDULE CALL (209)982-429J MANIFEST # C <br /> F01(C9511NH)B 96 SALES COPY <br />