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• - I <br /> I <br /> NON-HAZ*OUS WASTE MANIFEST <br /> 1 N P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> �SCry <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL-PROTECTIVE EQUIPMENT <br /> ❑,GLOVES []GOGGLES ❑RESPIRATOR LQHARD HAT <br /> MAILING ADDRESS` ' �' � � []TY-VEK ❑OTHER <br /> CITY,STATE,ZIP •. SPECIAL HANDLING PROCEDURES: <br /> �� '~ � - _ <br /> PHONEff.: " , <br /> ' COkACf PERSON ti <br /> SIGNATURE Or'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 /> 1 ❑ CONSTRUCTION SOIL ❑ ASH <br /> " ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 209 982- 1009 FAX <br /> NAME _ NOTES: TRUCK NUMBER <br /> ADDRESS �� V <br /> • CITY,STATE=,ZIP" <br /> PHONE i END,'DUMP BOTTOM DUMP TRANSFER <br /> EY ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) - FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 use11 1 <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 ❑ 501E <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 NUMBER; -,.-�w s :, M .'.. ...._r 1 .;., <br /> ❑ WOOD <br /> SIGNATLIRfOF AUTHOFiEZEI).AG NTi —~ tet DAi'E z' E <br /> ._ _ ASH <br /> \.. ❑ 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 SCHEDULE=D WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 57936 <br /> MANIFEST # <br />