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'f. _ k WARD-- NON-HAZARDOUS WASTE MANIFEST <br /> _� �� ��� WASTE TREATMENT AND DISPOSAL FACILITY ; <br /> +•, a INCORPORATED <br /> J013 ACCEPTANCE N0. 8$► 0�� ^ ti•; M <br /> 3�EQUIREDI*RsoNA PROTECTIVE EJ_( U'!'MN'f _� _ <br /> F 'U GLOVES []GOGGLES []RESPIRATOR ®HARD HAT <br /> MAILING ADDRESS cw ❑TY-VEK ❑OTHER <br /> S� _I SPECIAL HANDLING PROCEDURES <br />' ACF ,STATE,ZIP <br /> SIGNA AA _RIZED GE TLE DA <br /> i <br />' RECEIVING FACIUTX <br /> • WASTE T PEY� __ <br />' - ❑ SLUDGE FORWARD INC LANDFILL <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br /> DISPOSAL SOIL WOOD <br /> 9999 SOUTH AUSTIN ROAD <br /> • ❑ <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> •' GENERATING FACILITY (209) 982-4298 PHONE <br /> _ _ _ _ _ - <br /> .UM Moadde LXTI=P (209) 982- 1009 FAX <br /> NAME- MAI G• TRACTOR LIC # 32_(0 <br /> 1 TRUCK NUMBER <br /> LL ' TRAILER LIC #, W Q Il? <br /> .TCITY,STATE, ZIP . !`Sy�r ,g 4 J,,,�G�r TRAILER LIC # _ f- <br /> I <br />' -Pk <br /> HONE - _ /. L7I <br /> � ' � lhik ��� -- _ _ -- END DUMP BOTTOM DUMP TRAI�FER <br /> - R1ZED AGE�T OR•DRIVE DATE_ ROAFF(S) FLAT-BED VAN DRUMS <br /> SIGNATURE OF AlU _ _ ❑ ❑ ❑ ❑ <br />' CUBIC YARDS <br /> FORWARD INC. LANDFILL / <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 LASPOSE 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 OIL <br /> weather or other site conditions Forward shall notify the Disposer when site L� <br />' conditions are expected tochangesuch that Forward will be able to accept ❑ SLUDGE <br /> the waste <br /> NON-FRIABLE <br /> ASBESTOS• _ ❑ ASBESTOS <br />' FACILITY TICKET NUMBER _ �. r-' ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT _ DATE ❑ ASH <br /> *��� �'��r�' .�/ `i�� ❑ OTHER <br />' SCHEDULING MUSt BE MADE PRIOWTO 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) 982-4298SALES COPY MANIFEST # C Q'L3 <br /> F01(C951 1 NH)6 96 <br />