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r <br /> _ F ORWARD , <br /> NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> +i Y w <br /> ,1 SOB ACCEPTANCE N0. <br /> u- a_`� R�`QUIRED PERSONAL..Q EECTWE EQUIPMENT' ,. i* ---- <br /> ENERATOR '"�'- <br /> M� ,� X]GLOVES [3GOGGLES [:]RESPIRATOR ®HARD HAT <br /> MAILIN 7: DRESS - ❑TY-VEK ❑OTHER <br /> 321WeiRP=fteft SPECIAL HANDLING PROCEDURES <br /> lmkCA 95245 <br /> - <br /> PHONE ' -- , <br /> (299)943-2011 <br /> CONTACT PERSON <br /> Nick Hoewo _ <br /> r _ <br /> SIGNATURE OF-AUTHORIzED AGENT TITLE �A� ' <br /> WASTE TYPE _ — ---_ T_e --_ RECEIVING FACILITY <br /> ❑ SLUDGE FORWARD INC LANDFILL <br /> TREATMENT• OWOOD <br /> IL ❑ NON-FRIABLE ASBESTOS <br /> �] DISPOSAL SOI <br />' E] CONSTRUCTION 501E ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> • ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY __ _ _ __ __ _ (209) 982-4298 PHONE <br />' 444 Mowdale Road tATHROP (209) 982- 1009 FAX <br />' '/ TRACTOR LIG # -L 17� TRUCK NUMBER- <br /> AME <br /> NAME ,�(,{' 1` --- 14 C !1� -TAIC` <br /> ADDRESS is 3/-5_ S0t>Lt, TRAILER LIC # 1 x/bgl9 7 <br /> • CITY,STATE,ZIP &fire?_.. /-e// C,1 I ! TRAILER LIC # <br /> �--- - - END UMP BOTTOM DUMP TRANSFER <br /> PHONE _ _ �?� �Ci C * - _ _ ❑ ❑ <br /> 4 f�.►-� <br /> . SIGNATUR OF AU ORIZED AGE_I OR DRI-ER DATE RO FFSS) FLATBED - VA❑N DR�S <br /> FORWARD INC. LANDFILL cuBlc YADs _ <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 DIySPCSSE/BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the Y` " <br /> waste for any reason If Forward s refusal to accept the waste is based on SOIL <br /> weather or other site conditions, Forward shall notify the Disposer when sde <br />' conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • �IfMARKS N013-FRIABLE <br /> ASBESTOS <br /> F1LJ i TICKET NUMBER _ __ _ <br />' _ K - _ - - ❑ WOOD <br /> 516NAT UREjDF AUTHbRIZED AGENT_ / DATA <br /> - - ❑ ASH <br /> / ` ❑ 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 720224 <br /> FO IC951 INH)6-96 SALES COPY <br />