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FORWA. NON-HAZ US WASTE MANIFEST <br /> I ! N C O R P O R A 7 E WASTE TRE CT AND DISPOSAL FACILITY <br /> r _ <br /> JOB ACCEPTANCE N0. 1-768911 <br /> GENERATOR _ : REQUIRED PERSONAL PROTECTIVE EQUIPM€NT' <br /> oh err C3i) ❑t` GLOVES ❑GOGGLES [:]RESPIRATOR Q HARD HAT <br /> MAILING ADDRESS w - [ITY-VEK ❑OTHER <br /> CITY,STATE, ZIP , SPECIAL HANDLING PROCEDURES: <br /> PHONE i r•. j <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AG NT/TITLE DATI <br /> ' - <br /> WASTE TYPE � RECEIVING FACILITY ,. <br /> ❑ SLUDGE: <br /> ' ' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [] DISPOSAL SOIL ❑ WOOD t <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE E] OTHER MANTECA CALIFORNIA 95336 <br /> GENERATING FACILIT.y,. (209) ,Q82-4298 PHONE <br /> (200) 98.2- 1009 FAX <br /> NAME -- - - <br /> ._-.- -.-_ .-. ..- ---_ ,__ :-__ TRACTOR LIC. #�t� � � TRUCK NUMBER <br /> ',^ i� •', -� <br /> ADDRESS � <br /> TRAILER LIC. # <br /> CI Y, STATE,ZIP <br /> TRAILER LIC. <br /> rz <br /> PHONE END PUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTf IORIZED AGENT.OR DRIVER IbAf ROLL�O'FF(S) FLAT-BED VAN DRUMS <br /> * r ; �, � � ;�. ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS ; al <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 to accept the r DISPOSE 810 AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal 10 accept the waste is based on <br /> weather or other site condSOIL <br /> itions, Forward shall notify the Disposer when site 0 <br /> ' conditions are expected to change such that Forward will be abT? to accept -, <br /> the waste. SLUDGE <br /> REMARKS <br /> j —TNON-FRIABLE r <br /> ASBESTOS i <br /> FACILITY TICKET NUMBEIR� <br /> _. ❑ WOOD i <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> }f I f.� �.` ❑ 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 CAU.(209) 982-4298 <br /> FolSC951.NH)6-96 SALES COPY MANIFEST # C 110 0 <br />