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`-T <br /> . i� 1,UO <br /> O RSL A NON HAZARDOUS WASTE MANIFEST <br /> -! NCO R P O'R"A T E WASTE TRE NT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. F744911 <br /> `3 <br /> GENERATO�; ;'k;. .� REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> f`�S, iazt 0� ❑GLOVES ❑GOGGLES ❑RESPIRATORHARD HAT <br /> MAILING ADDRLSS" •" _,� ❑TY-VEK ❑OTHER <br /> CITY,STATE,ZIP.- <br /> SPECIAL HANDLIN PV OCEDURES: <br /> � <br /> , - .. _ _. <br /> SM J xArt Fri i•ca.CA 43 0 <br /> - PHONE ... <br /> CONTACT PERSON <br /> SIGNATURFy AUTHORIZJFD AGEPJT JTITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • 0 DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> El CONSTRUCTION 501E ❑ ASH ASH <br />' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br />' !==czs 'th sON (209) 982- 1009 FAX <br /> NAME TRACTOR LIC. # TRUCK NUMBER <br /> L!.L*z f _Ttl wIl2�. <br /> ADDRESS TRAILER LEC. # <br />' CITY,STATE,ZIP TRAILER LIC. # <br /> j"V; .-112A 93414 <br /> PHONE END!t; DUMP BOTTOM DUMP :,- TRANSFER <br /> ri;,;.;i-ry?Y4 E31:111 <br />' SIGNATURE OF AUTHORIZED AGENT OR DRIVERDATE ROLL-OFFS) FLAT-BED :. VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other ! 6 <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 <br /> weather or other site conditions,Forward shall notify the Disposer when site ❑ SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ' ❑ IVON-FRIABLE <br /> FACILITY T CKET-_NUMBERN _ ASBESTOS <br /> .. ❑ WOOD <br /> SIGNAT{}RE F AUTH&I D GENT DATE <br /> I ASH <br /> * p � . <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 # <br />' FOS IC9.x. MANIFEST C I INH)s-9s SALES COPY 63-9 2'3 8 <br />