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F@RWARD NON-HAZAI,� OUS WASTE MANIFEST <br /> WASTE TREA1�ENT AND DISPOSAL FACILITY i <br /> INC. <br /> JOB ACCEPTANCE N0. <br /> GENERATOR_ _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT f <br /> (;: ,, :-�., ,,r� / �.'.�. r fj' f ❑GLOVES ❑GOGGLES ❑RESPIRATOR _-]HARD HAT <br /> MAILING ADDRESS (3TY-VEK [:]OTHER j <br /> --I i l� •r SPECIAL HANDLING PROCEDURES: <br /> 1=`: CITY,STATE,ZIP <br /> PHONE <br /> CONTACT PERSONH . <br /> ' r <br /> E' SIGNATURE OF AUTHORIZED AGENT /TITLE DATE <br /> WASTE TYPE - RECEIVING FACILITY <br /> LCnIDISPOSAL <br /> MENT SOIL ❑ NON-FRIABLE SLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ <br /> solL ❑ woof9999 SOUTH AUSTIN ROAD <br /> RUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> _ , _- , ;;,� ,! ,.►�, - (209) 982-1009 FAX <br /> NAME. _ _. .-. _.:__.. _ _ ._ --- --- —� _ . DOES . x ..�_.�_. :.._� TRUCIC'NUMSER <br /> :. ADDRESS G. <br /> ` CITY,STATE ZJP <br /> r 11 r <br /> PHONE _. -.7. 1=NDDUM �TTOM DUMP_..- TRANSFER__ <br /> n Er <br /> SIGNATURE OF AUTHORIZED AGENTOR'DRIVER :' DATE ROLL-OFFS `'�, `,;:.FLAT BED-- :_:^VANS may"* piUMS <br /> { <br /> FORWARD INC. LANDFILL IgAlrl•�r�Q�„ <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 La Forward shall use <br /> n reasonable efforts to promptly notify Disposer of its inability to accept thef]ISPQSElO i �ERAT>w STOCKPILE ,_OTHER.. <br /> waste for any reason. If Forward's refusal to accept the waste is based on ❑ — <br /> n weather or other site conditions,Forward shall nosily 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 ❑NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMB <br /> _ _ _._�.; ❑ WOOD <br /> SIGNATURE QF AUTtiOR1ZED AGEIVT�;v�- .;_ .. Dt°!TE�- ; <br /> ❑ ASN <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(2091982-4298 MANIFEST # 14347 <br /> c�i Fc•;cnnv <br /> I <br />