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F&RWARD NON-HAZDOUS WASTE MANIFEST <br /> WASTE TRS MENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. _'_ <br /> GENERATOR REQUIREDPFFi$ON _PROTECTIVE_EQUIPMENT <br /> []GLOVES ❑GOGGLES ❑RESPIRATOR [-]HARD HAT <br /> MAILING ADDRESS rr' -- 1� ❑TY-VEK ❑OTHER <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATUR AUTHORIZ AGENT/TITLE DATE, <br /> 17 <br /> WASTE TYPE :_.�,��_:;� ..;; RECEIVG F lu :aE�«y .._ .�,.__� -•_ <br /> ❑ TREATMENT SOIL 0 NO SLUDGE wBLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ DISPOSAL SOIL [] WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> I <br /> NAME TRUCK NUMBER <br /> ri _2di.L. c� � f.z1 f.lkf KIN-] , IN., - - _ <br /> ADDRESS - <br /> 7 <br /> DDRESS S--�v <br /> CITY,STATE,ZIP ' <br /> 82 <br /> PHONE <br /> END DUMP- y., .. q..TTOM DUMP:•' TRANSFER <br /> y <br /> _ <br /> SIGNATURE.OF AUTHORIZED AGENT OR DRIVER DATE 130LL-0Fr=(S SLAT BE[)::' v VAN : DRUMS <br /> Kms' <br /> FORWARD INC. LANDFILL cuBicYARDs , �p F <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 <br /> impairs the safe and effective operation of the Landfill. Forward shall use DISPOSAL METHOD: `': (TO BE COMPLETED BY FORWARD) <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE 810 AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site ❑ SOIL <br /> conditions are expected to change such that Forward wilt be able to accept <br /> the waste. ❑ SLUDGE <br /> REMARKS •.. ' <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER. <br /> ❑ WOOD ' <br /> SIGNATURE AUTRD - <br /> � ..OF.._ . HO--.. ...IZE. .. .AG. .. . .ENT....-....._� .._� -----. --- - - ❑ ASH <br /> i <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 DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. ' <br /> 1 TO SCHEDULE CALL (209)982-4298 O 7 <br /> MANIFEST # <br /> I <br /> SALESCOPY <br />