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fir, FOR` WA% _ ' _ -_-� ' NON-HAZARDOUS WASTE MANIFEST <br /> y ; ! O R P O"R—A ° y WASTE TR NT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0, =744911 <br /> GENERATOR' REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> {; w,;;ly,CY:1 ❑GLOVES ❑GOGGLES ❑RESPIRATOR Q HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> • C„-r f Sm FY=_-'r,-n.CA 94'M <br /> - PHONE <br /> ,4.25.1 Sia-9235 <br /> CONTACT PERSON <br /> �SIGNATURE OO,F AUTHORIZED Aqj /�iTLE DATE <br /> WASTE TYPE ' RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> p DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> RIPON (209) 982- 1009 FAX <br /> NAME TRACTOR LIC.# TRUCK NUMBER <br /> i' s r •� � /7 r, f <br /> ADDRESS TRAC R LIC.# C� ✓ <br /> • CITY, STATE, ZIP TR4IL LIC.# <br /> PHONE END DUMP BOTTOM DUMP ' TRANSFER <br /> - <br /> SIGNATORE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED _ VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS,t <br /> � C s <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 <br /> NON-FRIABLE <br /> ❑ <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE. . <br /> ^ tr ❑ ASH <br /> / C. v ❑ OTHER <br /> SCHEDULING`MIJST 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 /> SCHEDULE CALL (249) 982-4298 "-,T0 <br /> Fo7 Jc95,+NH)6-95 SALES COPY MANIFEST # C ��.r <br />