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3 FORWARD ". NON-HAZARDOUS WASTE MANIFEST <br /> V►b <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> 405—ACCEPTANCE N0. <br /> aENERATO ' "_". Lti'11,1'- t. ` FREgUIRED ERSONAL PROTECTNE.EQUIPMENT " <br />' Md BttP&OICMt' ^®GLOVES []GOGGLES 0RESPIRATOR ®HARD HAT <br /> MAILING AIDDRESS' 'w' - ❑TY-VEK ❑OTHER s <br /> 521 West Pine Strd <br /> ;CITa' STA ZIP" SPECIAL HANDLING PROCEDURES <br />' • io�i,CA9S243 <br /> 009)943-2011 <br />' ;CONTACT PER, ON <br /> Nick B4aules <br /> ,SIG_ RE F AUTHORIZED AGENT! Tn1_E DATE_ _- <br />' .. * - + <br /> WASTE TYPE_' _ T _ - RECEIVING FACILITY - <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • El DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br />' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br />' GENERATING FACILITY (209) 982-4298 PHONE <br /> 4"Moaadsk IATHWP (209) 982- 1009 FAX <br /> .04,e ChD ' TRACTOR LIC # 9[-5-10 76 TRUCK NUMBER <br /> ADDRESS - - - - TRAILER LIC # /ke,57 y 7 <br />' CiTY,STATE_,ZIP o _3 <br /> � _ _� � f _� �� TRAILER LEC # <br /> P_HONE - 2_4n— --z>5 7— ; END DUMP BOTTOM DUMP TRANSFER <br /> _ _ ❑ ❑ El <br /> E� F AUTHOR _IZ AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> - - ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC (' <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 <br /> reasonable efforts to promptly notify Disposer of its inability to accept theDISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site ❑ SOIL <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste �W Y ❑ SLUDGE <br /> • I�EIuIARKS <br /> ' - - NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> �_� - - ❑ WOOD <br /> IGNATURE OF AUTHORIZED AGENT DATE <br /> - ❑ ASH <br /> /t . � �/ ❑ OTHER <br /> SCHEDULING MOST 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 720233 <br /> F01(C9511NH)6 96 SALES COPY MANIFEST # C <br />