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F ry <br /> V °x FORWARD r -w �z� NON-HAZARDOUS WASTE MANIFEST <br /> <y- �a�► INCIZ�' O A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> y + <br /> JOB ACCEPTANCE N0. 4� ' <br /> ~� _ <br /> J, <br /> 1\/ '� ' �� ` <br /> #" r 'W° REQUIRED PERSONA___ L PRO E�UIPIV <br /> L <br /> Md Buldo pift etmIll Kj GLOVES [:]GOGGLES [3 RESPIRATOR ®HARD HAT <br /> 1AILING ADD*" SS ❑TY-VEK ❑OTHER <br /> y5211 WeaMM SPECIAL HANDLING PROCEDURES <br /> 3YJ�7` STA "ZJP rl ' <br /> • kx%CA95243 <br /> PHONE — —�--- <br /> ' (2Q9}943-2p11 <br /> CONTACT.PERSON _ --- <br /> N idc Baeides <br /> S1G TUNA REOAUTHORIZED AGENT TITLE DATE__�_ <br /> • WASTE TYPE RECEIVING FACILITY <br />' ❑ SLUDGE N FORWARD INC LANDFILL <br /> • ❑ <br /> TREATMENTOILNON-FRIABLE ASBESTOS <br /> [� DISPOSAL SOILE] WOOD <br /> CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> • ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • _' _GENERATING FACILITY (209) 982-4298 PHONE <br /> _ _ _ _ - <br /> 444 hioembik RAAd LA.MMOP (209) 982- 1009 FAX <br /> NAME_ %&ht:9A �_ � �r `a TRACTOR LIC #(4& 5 f Gi /() - -TRUCK NUMBER_ <br /> ADDRESS _ _ W _ TRAILER LIC # VO 5.7 <br />' - - - -CA TRAILER LIC # _ <br /> . CITY_,STAT _E, Z1P � moo ' <br /> END D P BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTI ISDRIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-❑BED VA❑N w DRUMS <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 useDISP05E 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 ❑SOIL <br /> weather or other site conditions Forward shall notify the Disposer when site LJ <br />' conditions are expected to change such that Forward will be able to accept ❑ SLUDGE <br /> the waste <br /> • REMARKS —� -- NON-FRIABLE <br /> ❑ ASBESTOS <br /> 1 FACILITY TICKET NUMBER - Y ❑ WOOD <br /> IGNATUPE OF AUTHORIZED AGENT DATE <br /> ASH <br /> OTHER' �f, r __� `� `r- ❑ OTHER <br /> SCHEDULING MUST' TED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> MADE RIVAL.ONGOING DAILY DELIVERIIES MUST BEOR TO SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL <br /> UPON ARRIVAL. <br /> TO SCHEDULE CALL (209) 982-4298 MANIFEST # C 720225 <br /> F01[C9511NFO 6 96 SALES COPY <br />