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FOA NON-HAZA OUS WASTE MANIFEST <br /> - WASTE TREAWENT AND DISPOSAL FACILITY <br /> I � OORPORATE t <br /> JOB ACCEPTANCE X10., <br /> .: - - 744911 <br /> GENERATOR X REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> t C�t u it e tri Cry GLOVES []GOGGLES ❑RESPIRATOR HARD HAT <br />' <br /> MAILING ADDRESS TY-VEK❑ []OTHER <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br />' • Sc-zrts S=P.-w i.•-i2 C.k 940S,0 <br /> PHONE <br /> CONTACT PERSON <br /> ku;ry <br /> SIGNATURE PF AUTHORIZED AGENT/TITLE DATE <br /> fl <br /> ' WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> E❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSALSOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982--4298 PHONE <br /> ' 22_'C?=1':141:ab11:4:�Axv9j .IPO ; (209) 982- 1009 FAX <br /> NAME TRACTOR LIC.#' _ TRUCK NUMBER <br /> ADDRESS TRAILER LIC. # - ' <br /> - CITY, STATE, ZIP TRAILER LIC. # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> "� <br /> SIGNATURE- F AUTHORIZE[ OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN -':s DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS V <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 DISPOSE 810 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 /> _ ASBESTOS <br /> FACILITY TICKET NUMBER , <br /> _.. _. ._.. ❑ WOOD <br /> ' - SIGNATURE OF AUTHORIZED AGENT 'ATC: <br /> ❑ ASH <br /> OTHER <br /> V � <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 1 <br /> FOt IC95�;HH}b-85 SALES COPY MANIFEST # C 6 6 0 9.07- <br />