Laserfiche WebLink
-�Y,��� L•; I� YVJ�R r NON—HAZA US WASTE MANIFEST <br /> 5 s <br /> IN G D R O R A'T E D WASTE TREAINT AND DISPOSAL FACILITY <br /> JOB.ACCEPTANCE N0. 1768911 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> (-'_ .-~i I oil E]GLOVES ❑GOGGLES [:]RESPIRATOR Q HARD HAT <br /> MAILING ADDRESS A ❑TY-VEK ❑OTHER <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> ' • '�.s:�Tr.i�s`C.ia�`21'.lCI��.C..�4�.va<� .. <br /> PHONE <br /> f^CCG) 6-1-1006 <br /> CONTACT PERSON <br /> SIGNATUR OF AUTHORIZED, ENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> (] DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME TRACTOR LIC. # TRUCK NUMBER,. <br /> ADDRESS TRAILER LIG. <br /> wRoZO <br /> * CITY, STATE,ZIP TRAILER LIC.# <br /> PHONE END DUMP. BOTTOM DUMP TRANSFER <br /> Elr <br /> SIGNATURE OfwA HORIZE AGE6T OR DRIVEL DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> yX ❑ ❑ ❑ ❑ <br /> ..�... - <br /> — 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 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 io accept the DISPOSE B10 AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on EI—SOIL� <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 /> the waste. ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATOR OF_AUTHORIZED AGI=NT <br /> -L', ❑ 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 <br /> SCHEDULE CALL (209)982-4298 SALES COPY �� r1 <br /> l SC95 7 71JHS 6.96 MANIFEST # C 6 6 , n„ J. <br />