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f OR WA DNON-HAZARDOUS WASTE MANIFEST <br /> "r. �a,• <br /> INCORPORATE WASTE TIRE NT AND DISPOSAL FACILITY V I� <br /> JCB ACCEPTANCE NO. 1744911 <br /> GENERATOR .% REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> i r ©GLOVES [:]GOGGLES ❑RESPIRATOR ©HARD HAT <br /> npk.Oii OTHER <br /> MAILING ADDRESSTY-VEK-_• ❑ ❑ <br /> ' `60 M1 - SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> • >±;x>z.'s Sa.*>Frsn�rcv.CA 34w�+ <br /> PHONE <br /> f9:5)37,3-923S <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT /TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [� 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 /> - 1)y SwwirFagcx•rt fnq MOON (209) 982- 1009 FAX <br /> NAME TRACTOR LIC.# �j TRUCK NUMBER <br /> ADDRESS TRAILER LIC. # <br /> • CITY,STATE,ZIP TRAILER LIC. # <br /> PHONE END Dl1AAP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGER DRIVER DATE ROLL-OFFS) FLAT-BED. VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <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 �• DSpSE BIO AERATE STOCKPILE OTkiER <br /> waste for any reason. If Forward's refusal to accept the waste is based on ❑ 501E - <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•N6MBER. <br /> -._ v� - <br /> _. . . . ❑ WOOD <br /> SIGNATU>E OF At7�i-IO�IZtb AGENT':__ <br /> _ ❑ ASH <br /> `, ' r ` \ 1 _ /t ❑ 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 c V n C <br /> 'F01 IC951INH)6.96 SALES COPY MANIFEST # C J J <br />