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4 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> u (f- FO ,MR RD ",,- '- _ L :�� _ <br /> INC E D i ^•� �- 'WASTE TREATMENT AND DISPOSAL FACILITY <br /> - JAB ACCEPTANCE N0. <br /> fIE(:)f RED_PERSONAL PROTEPa%E EQUIPMENT"" "2 <br /> Mdsaidelivetmicum t []GLOVES E]GOGGLES ❑RESPIRATOR ®HARD HAT <br /> 1 N,aIL3NGADDRESS ❑TYVEK []OTHER ` <br /> 321 Weat Pine Shed <br /> 9SPECIAL HANDLING PROCEDURES <br /> 1 foka- -I <br /> �1��f�P y i <br /> • 93245 4 <br /> (HONE ` <br /> (209)943-2Dt! ' <br /> 'CONTACT PERSON <br /> I k Bond <br /> tSIGNATURE` F AUT THORIZED'AGEN !!TITLE DATE <br /> 1 f I <br /> • WAST STYPE _ _ __.__ RECEIVING FACILITY <br /> ❑ SLUDGES <br /> 1 ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFll L <br /> • DISPOSAL SOIL ❑ wooD -'9999 SOUTH AUSTIN RQAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> 1 ❑ STOCK PILE ❑ OTHER MANTECA, CALIFO�NlAk95336 <br /> -GENERATING FACILITY _ (209) 982-4298 PHONE <br /> 1 ".aMossidlak Road LATIMp (209) 982- 1009 FAX <br /> 1 NAME x _ r _-- -�_ _ -f TRACTOR LIG_ #------_ F - _ TRUCK NUMBER - <br /> ADDRESS , N'1 _ u TRAILER�LIC # <br /> • -L-63 <br /> CITY"STAVE,ZI TRAILER LIC # <br /> 1 // _ 59 - EN D MP BOTTOM DUMP - TRANSFER <br /> PHONE � 6J _W _ ❑ -�❑ <br /> SIGNATUR OF AUTHOR OR DRIVER_ DATE ROLL! F(S) FLAT-BED VAN DRUMS <br /> El El 1:1 <br /> 1 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 DISrOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> 1 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 IL <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 /> 1 the waste = ❑ SLUDGE <br /> • REMARKS 1 <br /> - '- NON-FRIABLE <br /> ❑ ASBESTOS <br /> 1 FACILITY TICKET NUMBER <br /> " - - - ❑ WOOD <br /> T IGNATURE OF AUTHORIZED AGENT _ DATE <br /> - -- - - - - - - - - ' ❑ ASH <br /> 1 * / ,r ,f !% �� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR 1 V 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298r�G U 22-C <br /> V <br /> FO (C9511NH)6 90 SALES COPY MANIFEST # C n <br />