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-F.FORWA RD `�r` -,�, NON-HAZARDOUS WASTE MANIFEST ' <br /> �.+ <br /> INCORPORATED t` WASTE TREATMENT AND DISPOSAL FACILITY <br /> � <br /> J,OBB�CCEPTANCE}N0. 14934W' ' v� 77 <br /> ENE - �'"- ` , ,- `'" ` '" REQUIRED PERS NALPROTEECT VE EQUIPMENT„ <br />' Md Hailes P 91GLOVES ❑GOGGLES [:]RESPIRATOR ®HARD HAT <br /> MU:N ADDRESS [:]TY-VEK []OTHER <br /> 521 Wed Pine Street <br /> •CITY STATE ZIP SPECIAL HANDLING PROCEDURES <br />' lakCA95245 - -- <br /> - PHONE <br /> ` <br /> ("9)943-"11 — <br />' CONTACT PERSON _ <br /> Ni'*Ronda <br /> SIGNATURE OF AUTHORIZED AGENT!TITLE DADA E <br /> WASTE TYPE- ._ _w _ _ __ RECEIVING FACILITY <br />' ❑ SLUDGE ' <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br />' GENERATING FACILITY _ �� yy_��_��}}��nn_ (209) 982-4 298 PHONE <br /> 4"�RemiAl Ll►iilH.OP r <br /> (209) 982- 1009 FAX <br />' AME TRACTOR LIC # 'TRUCK NUMBER <br /> - TVA w \1 - - - - -- <br /> ADDRESS _ TRAILER LIC # .- <br /> • g1TY,STATE,ZIP - TRAILER LIC # <br /> F0_N fj- �rj�J �/J/� .-`o. - END UMP -BOTTOM DUMP TRANSFER <br /> SIGNA URE OF AU-Q RIZED GENT OR DRIVER DATE ROLL- F S FLAT-BED VAN DRUMS <br />' ,� ❑ ❑ ❑ ❑ <br /> F t <br /> FORWARD INC. LANDFILL cuelcARDs _ <br /> J Forward sh � have no obligation to accept the waste if weather or other <br /> conditions impair a safe and effective disposal of the waste or rf the waste <br /> i 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 the DISPOSE BIO AERATE STOCKPILE OTHER <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 ETS <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • REMARKS~ ' _ <br /> Ei <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ...�_�. ..._. _ ❑ WOOD <br /> tIGNATURE OF AUTHORIZED AGENT DATE <br /> i -7 <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) 98274298 SALES COPY MANIFEST # C 720234 <br /> F01{G8511NH1 ti 96 <br />