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ORWANON-HA'�RDOUS WASTE MANIFEST <br /> l RD WASTE Tl ,TMENT AND DISPOSAL FACILITY <br />} INC JOB ACCEPTANCE NO. <br /> I GENERATOR �UR <br /> I RE_ .I.,.,_,ED <br /> .P_ERsoN4 PROTECTIVE EQUIPMENT <br /> F+ _ <br /> F Br-_.0Ta :��+'LTA"T'�'`' ❑GLOVES ❑GOGG-LES ❑RESPIRATOR 'HAT <br /> I a MAILING ADDRESS '' TY-VEK ❑ <br /> ;.. ..�.�., ---- -- r_-.�._�..: ❑ OTHER <br /> 10'2 4 i4 - <br /> - CITY,STATE,Zip SPECIAL HANDLING PROCEDURES. <br />+ - PHONE 1F <br /> tl. i 47 i- <br /> CONTACT PERSON <br /> SIGNATURE --AUTHORIZED /TtTLE� DATE <br /> - WASTE TYPE .-...- - - -._. - _._�.�_.ti.-__ _—.--.____�.._. _:�„�.r. RECEIVING4I=ACELITYY;,_._...__. _., _..__ .- -•_ -------.._._�._-_. <br />+ <br /> El TREATMENT SOIL p NON-FRIABLE ASBESTOS FORWARD INC. <br /> [3 DISPOSAL SOIL LANDFILL <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER <br /> MANTECA, CALIFORNIA 95336 <br />' GENERATING FACILITY <br /> �;s:r�c;�� f�La:.. � _.-.__ (209) 982-4298 PHONE <br /> 75` E ;iC.i Flc .` Et;ilE (209) 982- 1009 FAX <br /> l.cr �J r� ..z....._..._ --- --- _... .�... ..__...� .r r - <br /> NOTES TRUCK NUMBER - <br /> t ADDRESS 7e <br /> CITY,STATE,ZIP <br /> V <br /> PHONE <br /> END DUMP_- BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF S <br /> �J ...... 1-?T❑13ED.... O DRUMS <br /> r� <br /> FORWARD INC. LANDFILL cu6)c YARDS <br /> i r <br /> Forward shall have no obligation to accept the waste if weather or other 1.5 l.i'';: <br /> conditions impair the safe and effective disposal of the waste or if the waste <br /> impairs the safe and effective o DISPOSAL_ME_THOD'i. (TO BE COMPLETED BY FORWARD) <br /> reasonable efforts to operation Din of the Landfill. Forward shall use <br /> Promptly notify Disposer s oser <br /> Y p of its inability to accept the DlSP <br /> waste for any reason. If Forward's refusal .a;�.- _ _D$E =81D AERATE S7t]CKPIi E OTHER <br /> to the w .- <br /> waste is _ _ <br /> weather or other site conditions,Forward shall notifythe Disposer based on <br /> conditions are expected to ch Poser when site SOIL <br /> the waste. e such that Forward will be able to accept <br /> REMARKS - ❑ SLUDGE <br /> ❑ NON-FRIABLE <br /> ' FACILITY TICKET NUMBER ASBESTOS <br /> . . ❑ <br /> r SIGNATURE OF AUTHORIZED AGENT WOOD <br /> DLA .. . <br /> ..._. ..._J..�.....'rwiyf:.a'... <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 f <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> I TO SCHEDULE CALL(209)982-4298 <br /> SALES COPY MANIFEST * 12071 <br />