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��r� ��RWAR <br /> � 1v'ON-HAZA OUS WASTE MANIFEST <br />'- .�•:� INCORPORATE * <br /> WASTE TREAIWNT AND DISPOSAL FACILITY <br /> rJOB ACCEPTANCE N0. 749 <br />' GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 0i, 0 GLOVES ❑GOGGLES ❑RESPIRATOR Q HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 2s;. �i :ik C._r�°xt <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> • S= r&a6�.:o.CA 9".0 } <br /> - PHONE <br /> (G: %.3-9239 <br /> CONTACT PERSON 1 z + <br /> SIGNATTE AUTHORIZED&NT,/TITLE DATE <br /> ' WASTE TY)E RECEIVING FACILITY ` <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> * Q DISPOSAL SOIL ❑ wool) 9999 SO UTH AUSTIN ROAD <br /> El CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME TRACTOR LIC. # SL TRUCK NUMBER <br /> ADDRESS TRAILER LIC. # Z 3 <br /> • CITY,STATE,ZIP TRAILER LIC- # <br /> PHONEEND DUMP., BOTTOM DUMP TRANSFER <br /> [[ <br /> El El <br /> SIGNATURE OF 'UrHORIZED AGENTOR-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 /> A. <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 DISPOSE E110 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 OB61L <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 NUMBER <br /> - Cl WOOD <br /> SIGNATUR OF:,AUTHORIZED�GENT DATE_ <br /> ❑ ASH <br /> . �i i } ,'� y ti �� 7 �\JJ� ❑ 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 /> FO (CB5IINH)6.96 SALES COPY MANIFEST # C u 7',� <br />