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NON-HAZArj)US WASTE MANIFEST <br /> RWADRWASTE TREATMENT AND DISPOSAL FACILITY <br /> INE' JOB ACCEPTANCE NO. •~� t t � 5 <br /> J GENERATOR REQUIRED PERSONA4 PROTECTIVE EQUIPMENT <br /> ISI: k'.i:•. ;'s!i i.:.. :1' 'l r`:'!'1:.- [:]GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> { MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> I <br /> 'CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> PHONE E 1: <br /> I J CONTACT PERSON' <br /> SIGNATURE O AUTHORIZED)`GENT� /TITLE DATE <br /> WASTE TYPE RECEIVING FACILI Y':� <br /> "I ❑ <br /> SLUDGE <br /> [3TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> Ur ❑ DISPOSAL SOIL [].WOOD 9999 SOUTH AUSTIN ROAD <br /> #-n ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA- CALIFORNIA 95336 <br /> t GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982-1009 FAX <br /> 4•:�:• E'=.� C l� i:.. ._ ::a;it;: <br /> 8E <br /> _NAME NOTES: , _ ......-._.... . TRUCK NUM R. - <br /> ADDRESS -`-` - <br /> CITY,STATE,ZIP - <br /> `. PHONE ' END pUMI'..>:�. �,i -BOTTOM DUMP TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE F_-, .; ,'. •_, ,ROLL-OFF(4y. .__ . T BED VAN DRUMS <br /> �----- � . ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste it weather or other <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD:1 (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> y+ reasonable efforts to promptly notify Disposer of its inability to accept the __- DISPOSE BIO AERATE STOCKRLE OTHER <br /> waste for any reason. It Forward's refusal to accept the waste is based on SOIL <br /> a 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 /> r, REMARKS - <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE.`.; El ASH <br /> 7�C ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4.04 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> 5UBjECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> l'O SCHEDULE CALL(209)962-4298 12063 <br /> I nG O 6 3 <br /> MANIFEST # 1. J <br /> C A 1 CC f�I.1hV <br />'l J <br />