Laserfiche WebLink
1 .�� NON-HAZN- - JUS WASTE MANIFEST <br /> WARD U WASTE TREANT AND DISPOSAL FACILITY <br /> 11vc' JOB ACCEPTANCE NO. � <br /> GENERATOR REQUIRED.PERSON PROTECTIVE EQUIPMENT <br /> itli ❑GLOVES ❑GOGGLES [:)RESPIRATOR. ❑HARD HAT <br /> f .MAILING ADDRESS ❑TY-VEK ❑OTHER <br />{j !+I:: i '-.4 SPECIAL HANDLING PROCEDURES: <br /> �. CITY,STATE,ZIP <br /> �",PHONE ! i <br /> r�,1tt CONTACT PERSON <br /> SIGNATURE OF AUTHORIZZEg.�AGENT /TITLE DATE _ <br /> WASTE TYPE <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ DISPOSAL SOIL ❑ WOOD gggg SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL [—]'ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> IL!, ' : .''ED1Lft: (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> H ,til. M :: .ON" (`�;U:' I:1�� , LtoC ._. ., <br /> ADDRESS __...- <br />} <br />} " CITY,STATE,ZIP <br /> PHONE DUMP __ ¢07TOM DUMP TRANSFER <br /> j y SIGNATURE OF-AUTHORIZED AGENT OR DRIVEfl = DA E VAN DRUMS _ <br /> CUBIC YARDS ; <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 if the waste DISPOSAL METHOD:;. (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> n 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 SOIL <br /> ii 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 /> r i FACILITYETN NUMBER <br /> UMB R <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED_AGENT <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 /> SUl3.]ECT 70 REFUSAL UPON AnRIVAf_.ONGOING DAILY DELIVERIES MUST 13E SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(200}982-4298 MANIFEST # 12069 <br /> car t+c rnnv <br />