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0*. ORFWAYP, NON-HAZAR US WASTE MANIFEST <br /> ! N C O R P O R A WASTE TREATO]T AND DISPOSAL FACILITY <br /> -`; JOB ACCEPTANCE N0, 76891 1 <br /> QENERATOR REOUIRED PERSONAL PROTECTIVE EOUIPMENT <br /> Chtt>Fin Oil E]GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS - _ ❑TY-VEK ❑OTHER <br /> 260,14kbelk Cc= <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> S:K=h San sF: L-0,CA 940$0 <br /> PHONE <br /> 467-1 W6 <br /> CONTACT PERSON <br /> P is i irjL- <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> t ❑ SLUDGE <br /> ❑ TREATMENT SOIL [❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL [3 WOOD SOUTH AUSTIN ROAD <br /> ❑ <br /> CONSTRUCTION SOIL ❑ ASH ASH <br /> fp ❑ STOCK PILE El OTHER MANTECA, CALIFORNIA 95336 <br /> _ GENERATING FACILITY (209) 982-4298 PHONE <br /> =-5c-2, liu-N9-f-SOUL RIPON (209) 982- 1009 FAX <br /> NAME. i TRACTOR LIC. # ` TRUCK NUMBER <br /> r- '- )<i <br /> 1 rj <br /> ADDRESS TRAILER LIC. # �. <br /> • CITY,STATE,ZIP TRAILER LIC. # <br /> I PHONE' i ENOPUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS, <br /> i Forward'shall have no obligation to accept the waste if weather or other <br /> con8itions 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 shah use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the �� DISPOSE SIO AERATE STOCKPILE OTHER <br /> wade for any reason. If Forward's refusal to accept the waste is based on 'SOIL <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 /> ` she waste. _ ❑ SLUDGE <br /> REMARKS <br /> NON-FR"LE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> .,_ ❑ WOOD <br /> SIGNATURE OF AUTHO> IZED AGENT DATE <br /> ❑ ASH <br /> OTHER <br /> CHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> F SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> SCHEDULE CALL (209) 982-4298 <br /> sc9 ;MSI E•Qs SALES COPY 5 760 <br />