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NON-HAZAI-)JUS WASTE MANIFEST <br /> �� � WASTE TREA-WfENT AND DISPOSAL FACILITY <br /> J013 ACCEPTANCE NO, <br /> GENERATOR REQUIRED PERSON <br /> 4.PROTECTIVE EQUIPMENT <br /> El GLOVES EIGOGGLES [—]RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS E]TY-VEK -DOTHER <br /> CITY,STATE,ZIPSPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT PERSON <br /> 4 <br /> SIGNATURE -,AUTHORIZEDAG NT/TITLE DATE <br /> WASTE TYPE rr <br /> RgqEIYINP FA <br /> asp ❑ SLUDGE <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> DISPOSAL SOL 0 WOOD <br /> 9999 SOUTH AUSTIN ROAD <br /> C3 CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER <br /> MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> I"IE.E. LR;4 I-CI D ,P <br /> I J , <br /> 17-'aC1 P1 A E 0 UL" (209) 982-1009 FAX <br /> NAME - NOTES: TRUCK NUMBER <br /> :E i, . <br /> -T[' —F Tlli-." . <br /> 4 ADDRESS <br /> CITY,STATE,ZIP <br /> C.". <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> k. <br /> E) El 0 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OMS).. --JI-AT-13E.0 VAN DRUMS <br /> 13 11 <br /> A <br /> FORWARD INC. LANDFILL <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 it the waste DISPOSAL METHOD., (TO BE COMPLETED BY FORWARD) <br /> impairs the sale and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DiSP(?SE B10 AERATE STOCKPILE OTHER <br /> waste for any reason. it Forward's refusal to accept the waste is based on <br /> At weather or other site conditions.Forward shall notify the Disposer when site SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> it REMARKS <br /> [3NON-FSLABLE <br /> ASBESTOS <br /> k—? FACILITY TICKET NUMBER.. <br /> ❑ WOOD <br /> 'SIGNATURE OF AUTHORIZED AGENT DATE <br /> 16 <br /> 0 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 DEUVEIIIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFOlif— <br /> TO SCHEDULE CALL(209)OB2-4298 MANIFEST # 12059 <br />