Laserfiche WebLink
i1�YYJ�R 'NON—HAZAUS WASTE MANIFEST <br /> C O R P O R A T E D ;,' WASTE TREA NT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. 744911 <br /> GENERATOR : :. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GLOVES []GOGGLES ❑RESPIRATOR ©HARD HAT <br /> ' ` E]OTHER <br /> MAILING ADDRESS ❑TY-VEK <br /> 2E 114i2wle COOL-1 <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> ' . bout$&m Frz=izco.CA 9438;3 <br /> PHONE`- <br /> (111?S)S73-n33 <br /> ' CONTACT PERSON ! <br /> R u'z-s <br /> SIGNATUR�OF AUT}jORF D AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ' ❑ 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 (209) 982-4298 PHONE <br /> <'1- . a (209) 982- 1009 FAX <br /> i <br /> NAME - TRACTOR LIC.# TRUCK NUMBER <br /> ADDRESS TRAILER LiC. # <br /> ­ 11 <br /> • CITY,STATE, ZIP TR�LEA LIC.# <br /> I, ,CA 934 14 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> El <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other r' <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 �r <br /> weather or other site conditions,Forward shall notify the Disposer when site Ll 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 /> _..,1 ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ' t ❑ WOOD <br /> - SIGNATU4E OF AUT IZED ENT ATE <br />,f ❑ ASH <br /> 7�C t OTHER <br /> t <br /> SCHEDULING.MUST BE MkDE 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 SATES COPY MANIFEST# C n <br /> FO1 IC95i�H�I 6-P6 0 0 L+776 <br />