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I, F"ORWA] ]4NON-HAZEOUS WASTE MANIFEST <br /> INpO RAWASTE TRNT AND DISPOSAL FACILITY <br /> TS <br /> JOB ACCEPTANCE NO. [767 911 <br /> NERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ff]GLOVES [:]GOGGLES ❑RESPIRATOR HARD HAT <br /> ' MAILING ADDRESS ' ❑TY-VEK ❑OTHER <br /> 26,0 hfilbege P <br /> CITY,SSPECIAL HANDLING PROCEDURES: <br /> TATE,ZIP � - <br /> t • ScWth S=FranciscV.CA94080 <br /> - PHONE <br /> CONTACT PERSON <br /> M1 I.iit <br /> SIGNATURE F AUTHgRIZED AGENT /TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • p 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 /> (209) 982- 1009 FAX <br /> NAME TRACTOR LIC.# TRUCK NUMBER <br /> ADDRESS TRAILER LIC. # <br /> C,115 Roma <br /> • CITY,STATER ZIP TRAILER LIC.# <br /> 5�a E—•-d i,,,CA 9330$ <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS , <br /> Forward shall have no obligation to accept the waste it 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 the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on 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 ,*f <br /> _ .. ..... NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKfT NUMBER <br /> . . . .._ _.._ .�,,.-...._. .._. .. . . ..,. . -_.��, -._ ❑ WOOD . <br /> SIGNATURE OtF AUTHORIZED,AGENT. DATE <br /> _ ; I. .. 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) 982-4298 SALES COPY MANIFEST # C �, v �. <br /> f01 1C95 r zNH)s-96 11 <br />