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RWA�� NON—HAZAOOUS WASTE MANIFEST ` <br /> .�: 4 <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> —�' JOB ACCEPTANCE NO. a` 4z 3 <br /> GENERATOR- �' <_.•_.�f.`.... _ :_ :- REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 11• <br /> 7Y-VEK <br /> ❑43LAVES F]GOGGLES Q RESPIRATOR ©HARD HAT <br /> € C' <br /> MAILING ADDRESS:,�;. - � -,' �, : ❑ ❑OTHER <br /> CITY,STATE, ZIP. _ SPECIAL HANDLING PROCEDURES: <br /> rz <br /> PHONE-". _ <br /> ! .� �- . ✓fes J - - - - <br /> CONTACT PERSON <br /> SIGNATURE O AUTHORIZED AGENT/ TITLE DATE ' <br /> WASTE TYPE:. RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ' ' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑' DISPOSAL SOIL ❑ wooD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982— 1 009 FAX <br /> - �,•�;� '�� "-.;�,•� 7 /' �- •,�-iii.? l <br /> NAME _ NOTES: TRUCK NUMBER <br /> ADDRESS <br /> . CITY,STATE, ZIP <br /> • PHONE END DUMP N. BOTTOM DUMP TRANSFER, <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OF_F(S), FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> r <br /> 3 ' <br /> FORWARD INC. LANDFILL <br /> CUBIC YARDSs <br /> Forward shall have no obligation to accept the waste if weather or other j <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 [Asposer of its inability to accept the DISPOSE BIO_- AERATE STOCI<PoLE OTHER <br /> waste for any reason. 11 Forward's refusal to accept the waste is based on ❑ SOIL <br /> y <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 ... <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET <br /> -` WOOD <br /> SiGNATURIJOF;4�1THORIZ €}AG N7 t1. -" DATES <br /> ❑ ASH <br /> ❑ OTHER ; <br /> i <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. I <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST# 57931 <br /> ! <br /> car F:c nnl7V <br />