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FSRWARLI NON—HA74RDOUS WASTE MANIFEST <br /> WASTE Ti,wvtTMENT AND DISPOSAL,FACILITY <br /> INC. JOB ACCEPTANCE NO. 04 — 6 qi . i <br /> ti GENERATOR REOUIRED_PERWP4,,4 PROTECTIVE EQUIPMENT -- -- -. <br /> •'J'+_ 1�'i i f-�!'I"t?F ': _ ==r�]..-_1'z.^ - -- ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT' <br /> MAILING ADDRESS ❑TY VEK ❑OTHER <br /> 10`4 t¢ . F-01 I!d -iii-1-1 <br /> f, <br /> CITY,STATE,ZIP �: SPECIAL HANDLING PROCEDURES: � <br /> Y - ._��_... <br /> PHONE = D . 13 <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHO_RIZED AC �f f/TITLE `_`_ DATE <br /> WASTE TYPE. :,. ..REGErIY�I�G FACILITY <br /> ❑ SLUDGE ' <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ alsPosAL solL ❑ wooD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA CALIFORNIA 95336 <br /> GENERATING FACILITY 209) 982-4298 PHONE <br /> �� r a;z C. �r Eir`I.I 4209} 982-1049 FAX <br /> NAME ;x_ .. _ a W:L: �yNOS. �>. . ---. �:.�TRUCK NUMBER <br /> TRUCKING <br /> ADDRESS _ �._,�. .. ILA 1 <br /> 1i i9'.i ELDER MC REEF- r,C.AD <br /> . CITY,STATE ZIF? <br /> i PHONE END DUMPa..--, , BOTTOM DUMP-..._-- --TRANSFER <br /> ' <br /> i 1 i✓ ' 1-g' 6 4 p� ❑ - ❑ <br /> . . .. _ <br /> SIGNATURE OF AUTHORIZED_AGENT OR i]RI_VER GATE ;' ROLL-0FFLSL` �i,FLAT- ED S <br /> B VAN ARUM #f <br /> a � <br /> I CUBIC YARDS <br /> FORWARD INC. LANDFILL1.3 <br /> Forward shalt 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:_; <br /> (TO-BE COMPLETED BY FOF{WARD} <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO- AERATE 13TOCKPILE . OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on SOIL <br /> weather.or other site conditions,Forward shall notify the Disposer when site <br /> conditions are expected to <br /> change such that Forward will be able to accept <br /> • the waste. ❑ SLUDGE <br /> ` REMARKS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> _ . . ❑ WOOD <br /> Y <br /> SIGNATURE OF AUTHORIZED AGENT.,: �_Y.__ DATE; <br /> _- . ❑ ASH <br /> t * <br /> 0T HER <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 /> TO SCHEDULE CALL(209)982-4298 <br /> MANIFEST # 12073 <br /> SALES COPY <br />