Laserfiche WebLink
11�� <br /> FORWAR- ' • NON—HAZA OUS WASTE MANIFEST <br /> �• I U P O R A TWASTE TRENT AND DISPOSAL FACILITY <br /> COR <br /> n JOB ACCEPTANCE NO. <br /> - 744911-: <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ®GLOVES ❑GOGGLES ❑RESPIRATOR ED HARD HAT <br />' MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> C('LL't SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE, ZIP <br /> • <br /> 5=1h Ein Frew o.C-A 940-SO <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATUI3,E:OF AUTHORIZED AGENT/TITLE DATE <br /> :r r <br /> M <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • p DISPOSAL SOIL ❑ WOOD 9 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 999 <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> „�z, �I� pK,,� (209) 952- 1 009 FAX <br /> NAME TRACTOR LIC.# TRUCK NUMBER <br /> ADDRESS TRAILER LIC.# l ;: {. L r' <br /> • CITY,STATE, ZIP. TRAILER LIC.# <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> El <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> �! ❑ ❑ Cl ❑ <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 DISPOSE 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 ❑ 501L.. <br /> ' conditions are expected to change such that Forward will be able to acRFI.,. <br /> the waste. `- ❑ SLUDGE <br /> REMARKSEi NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZEf AGENTY_ i DATEw <br /> 1 1 _�j. -.:_ ❑ ASH <br /> r <br /> 7(C } ! •� '.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 "]1'1 <br /> FOI(gg95 INH)C-96 SALES COPY MANIFEST # C 6" of'�3. <br /> — — _ - -- - - - - -- - - - - --- -- — -- -_ - - --- - - -- - -- - -- r <br />