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FORWA) NON-HAZp <br /> OUS WASTE MANIFEST <br /> ! N t'72 P 4 RAT WASTE TR TENT AND DISPOSAL FACILITY <br /> ` -'_2 -r, JOB ACCEPTANCE NO. <br /> 1744911 <br /> GENERATOR : - REQUIRED PERSONAL PR07ECT1VE 1"QUfP111=NT <br /> G�sr,�ri Oi> ®GLOVES ❑GOGGLES ❑RESPIRATOR' Y❑HARD HAT <br />' MAILING ADDRES <br /> ❑TY-V <br /> S EK [I OTHER <br /> nf,;a itleae Court <br /> CITY,STATE, ZIPSPECIAL HANDLING PROCEDURES: <br /> S-0th San Frarsoa.C.4.9400.'J <br />' - PHONE _. <br /> CONTACT PERSON <br /> R uAy <br /> SIGNATURT OF AUTHORIZED�I�,PJNT/ TITLE DATE <br /> tWASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ' ❑ STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME T TOEi LIC.# TRUCK NUMBER <br /> ADDRESS TRAUt R LICA <br /> • CITY, STATE,ZIP TRAILER LIC.# f <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (5 Fl o:;-03 4 / 1! 11 1:1UT <br /> SIGNATU E OF ORIZED AGENT <br /> g DRIVER DATE ROLL-OFFS} FLAT-BED , VAN DRUMS <br /> J1 '� � � } !`'- ,fir ��', � ❑ <br /> . n <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligalion 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 sate and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the D)SPOSE 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 /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> _ _... ❑ WOOD <br /> SIGNATURE-OF AUTHORIZED AGENT DATE <br /> _ ❑ ASH <br /> L <br /> ❑ OTHER <br /> CHErDULING 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 /> 01 IC9511NH)6-96 SALES COPY MANIFEST # C 60 3 v 4 <br />