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� � F <br /> F,� _ O <br /> 1t VV��� - NON-HAZARDOUS WASTE MANIFEST <br /> v► INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> P <br /> �� JOB ACCEPTANCE N0. 40_0': <br /> Y <br /> E' 7 n� """ .BEQU BRED PERSONAL",PROTEC77Vq_EQUIPMENT <br /> 1►+1d 81111 FdrQk= FK]GLOVES [:)GOGGLES ❑RESPIRATOR ®HARD HAT <br />' #V�A'IL1NG_A17D>�ESS -, - t [:]TY-VEK ❑OTHER <br /> 521 � a'� <br /> 3Ci ZEP SPECIAL HANDLING PROCEDURES <br />' • bd4L'A 93245 <br /> - 'PHONE.7-"•_ � <br /> (209)943-2011 <br /> CO-NTACT.PERSON <br /> Nick Haddeg <br /> SIG l R QF AUTHO IZED AGENT/ TITLE DATE ZZ <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> CONSTRUCTION SOIL ❑ ASH <br />' ❑ STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY _ _ (209) 982-4298 PHONE ` <br />' 4"Mow&le kmd LATIMOP (209) 982- 1009 FAX <br /> e-1 -r,4 v !fl f a InK C O C TRACTOR LIC # (U-7�7 a TRUCK NUMBER <br /> ADDRESS - v TRAILER LIC # S VO-5-744"'7 <br />' • CITY,STATE,ZIP t400l t ICC4 TRAILER LIC # t <br /> •• `_ _ - _ V 3 � � <br /> PHONE 2 T <br /> vC1 -- �- _ END DUMP BOTTOM DUMP _ TRAN❑SFER <br /> SIG RE OF AUT ORIZED AGENT OR DRIVER DATE ROLL-OOFFF(S) FLAT-BED VAN DRUMS_ <br /> ❑ ❑ ❑ ❑ <br /> i <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> �f <br /> Forward shall have no obligation to accept the waste if weather or other 1 <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 the DI5 SE BIO AERATE '§TOCKPILE OTHER <br /> waste for any reason If Forwards 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 acce <br /> the waste _ - - - rt E] SLUDGE <br /> � REMARKS ' <br /> NON-FRIABLE <br /> TM _ ❑ ASBESTOS <br /> I FACIUTY TICK T NUMB <br /> -- -- — -- — r ❑ WOOD <br /> ^I ~�E OFA ORI AGENT DATE <br /> _ -- - �� ❑ ASH <br /> I ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> ISUBJECT TO REFUSAL-UP09 ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209) 982-4298 E <br /> FO (C951 INH)6 96 SALES COPY MANIFEST # C 720235 <br />