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. 7 <br /> FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> Y �►� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO.x i s <br /> r <br /> �EF�iATOR ''' Y "� �EQUIREDPER50NAL PROTECTIVE EQUIPMENT <br /> Md Baides Pdrokim GLOVES []GOGGLES ❑RESPIRATOR ®HARD HAT - <br />' IMILING,ADDRIESSf i ❑TY-VEK []OTHER <br /> �C13Y STATZIP - SPECIAL HANDLING PROCEDURES <br /> PHONE,, ' <br /> ' (2�9�9�-21311 <br />' CO� NTAff PE SON <br /> - <br /> SIGIVATURE OF ALITHORIZED AG /TITLE DA '- <br />' WASTE TYPE - RECEIVING FACILITY <br />' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ wool) 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY r _ _ _ (209) 982-4298 PHONE <br /> 444 Moas"RoW LATHROP (2 09) 982- 1009 FAX <br /> IAME _ _ C `t' ,� C TRACTOR LIC #j7A4 _TRUCK,NUMBER <br /> ADDRESS ,� - TRAILER UC <br /> • CITY,STA_TE, ZIP_ TRAILER LIC # <br /> PHONE r - ENSIUMP , BOTTOM DUMP TRANSFER <br /> GNATURE OF 61T RIZED AGENT OR DRIVER DATE ROL -O F(S) FLAT BED VAN DRUMS <br /> 44, <br /> I FORWARD INC. LANDFILL CUBlC YAR(�S/ <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 MEf D (TO BE COMPLETED BY FORWARD) <br /> I 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 POSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste Is based on ] S 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 /> Ithe waste ❑ SLUDGE <br /> • WEM.4 KS w t <br /> r NON-FRIABLE <br /> FACJUTY TICKET�NUMBER - ; � � ❑ ASBESTOS <br /> I - l - - <br /> WOOD <br /> NATUR OF AU - ❑ <br /> IGTHORIZED AGENT_ DATE <br /> - Et ❑ 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 /> O SCHEDULE CALL{209 982-4298 <br /> F SALES COP f MANIFEST # C 7 20236 <br /> D1�C8511NH)6-86 f <br /> e <br />