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_"' T0RWA j NON-HAZARDOUS WASTE MANIFEST <br /> I N C O R P O R A T E ° ° WASTE TRE NT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. 174, 4911 <br /> GENERATOR<` fl y <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> OI+'miam Oil E]GLOVES [:]GOGGLES ❑RESPIRATOR 0 HARD HAT <br /> MAILING ADDRESS []TY-VEK ❑OTHER <br /> .60�.jjjjdje CtrE SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE, ZIP <br /> • Sotnh SIM F eau in_Z.CA 94080 <br />' - PHONE <br /> (92-5)8-,--1-923€ <br /> CONTACT PERSON - <br />' SIGNATURE l AUTHOIIZ AGENT/ LE DATE <br />' WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • E] DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br />' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br />' ISINi�41_M*—wa;'95 .` (209) 982- 1009 FAX <br /> NAME TRAGQ$}� # �� TRUCK NUMBER <br /> ADDRESS TRAILER�jLIC,- <br /> ?. 3 Ct'l,�Box�19 i fi <br /> CITY, STATE,ZIP TRAILER LIC. # <br /> PHONE ENq DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> �' 'a _ r j ;r ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation 10 accept the waste if weather or other <br /> conditions impair the sate and effective disposal of the waste or if the was DISPOSAL MET IOD; (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 STOCKRLE OTHER <br /> waste for any reason. If Forward's refusal to accent 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 /> ' : ❑ NON-FRIABLE <br /> FACILITY TICKET ASBESTOS <br /> BER'_.,, - � -' - <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> A ❑ 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 <br /> 'FO1(C951 INH)6.96 SALES COPY MANIFEST # C 6 63, <br />