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FoRvVAR16;;• �►-+: CON-HAZA�OUS <br /> WASTE MANIFEST <br /> lNCORP � KATE ❑ 4 WASTE TREAENT AND DISPOSAL FACILITY <br /> r,JOB ACCEPTANCE N0. 7449 .1 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> [!0 GLOVES ❑GOGGLES [:]RESPIRATOR HARD HAT <br />' MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 26 �,`i,�llr:CE�zst <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> Se:,usi San F: a;C4,94080 <br /> PHONE <br /> ' CONTACT PERSON <br /> ii wkv <br /> SSIIGNATURfEP.F AUTHORIZED ACf3NT / TITLE D E , <br /> WASTE T E RECEIVING FAC!l..iTY <br /> ' ❑ SLUDGE <br /> E:1 TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (2Q9) 982-4298 PHONE <br /> --2 j2 s"-,us.s (2 0 9) 9 8 2- 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 /> El 0 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VANDRUMS <br /> El El <br /> ❑ ❑. <br /> i 1 :f �J- <br /> FORWARD INC. LANDFILL CUBIC YARD_ , <br /> Forward shall have no obligation to accept the waste if weather or other ( i <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 DIdPOSE BIO 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 j NON-FRIABLE <br /> ;. ❑ ASBESTOS i <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZ4XGE T DATE <br /> ❑ ASH <br /> E] OTHER <br /> SCHEDULING MUST BE MADE PRIOR TJ 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> FolUBJECT TO REFUSAL UPON_ABRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> SCHEDULE CALL(209) 982-4298 4C951 INH)6-96 • MANIFEST # C 6�y;; 0 J 10 <br />