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NON-HA7 4RDOUS WASTE MANIFEST <br /> WARDFORWASTE TF%wATMENT AND DISPOSAL FACILITY <br /> 11VC. JOB ACCEPTANCE N0, 1 , <br /> �> GENERATOR _ REQUIRED•PERSONALPROTECTIVEEQUIPMENT .�_. <br /> GLOVES ❑GOGGLES ❑RESPIRATOR []HA RD HAT <br /> MAILING ADDRESS ❑TY VEK ❑OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP i <br /> T <br /> Gam. � • <br /> PHONE .. <br /> CONTACT PERSON _ <br /> 1,7 <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> I — WASTE TYPE . .. - _ RECEIVING FACIIJTY ; <br /> ❑ SLUDGE <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> M <br /> GENERATING FACILITY. : . <br /> 7 :T_.... _:�..:._. (209) 982-4298 PHONE <br /> (209) 982-1009 FAX <br /> NAME <br /> TRUCK NUMBER_., <br /> ADDRESS <br /> . CITY,STATE,ZIP. : <br /> PHONE <br /> ( 4/rL :��/ . � �_ _�� .,<: .EN SUMP , .1 BOTT a DUMP _...TFLAN❑SFER_ <br /> SIGNATURE,OF AUTHORIZENT <br /> D AG DRIVER QATE <br /> 6LL-0 S f FLAT-BED �: VAN - DRUMS <br /> FORWARD INC. LANDFILL cueic_YAo .: <br /> t Forward shaft have no obligation to accept the waste if weather or other l� <br /> 1 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 /> reasonable efforts to promptly notify Disposer of its inability to accept the '"DISPOSE :,610_. 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 will be able to accept <br /> the waste. ❑ SLUDGE <br /> ` REMARKS , <br /> ❑NON-FRLAHLE <br /> FACILITY TICKET NUMBER, ASBESTOS <br />{ .-. .-. . . .. _..-_. .. . .._. .._...------....,....=;u.., _. - - E] 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 /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 12074 <br /> SALES COPY MANIFEST # <br />