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POR I�!�IRD a NON-HAZAUS WASTE MANIFEST • WASTE TREA11WNT AND DISPOSAL FACILITY 1 /IVC. J0B ACCEPTANCE NO. - 4/�y7 j nnRATOR _ R IRED PERSONAL PROTECTIVE EQUIPMENT GLOVES ❑GOGGLES ❑RESPIRATOR []HARD HAT AILING ADDRESS [:]TY-VEK [:]OTHER Zy'/ "9 r-f 1.4 / w� SPECIAL HANDLING PROCEDURES: ITYys71 jTE,ZIP _ - i l .-7 y 7 y_� sic HONE ONTACT PERSON SIGNATURE OF AUTHORIZEU.vW'tNT/ TITLE DATE • WASTE TYPE RECEIVING FACILITY ❑ SLUDGE TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH • ❑ OTHER MANTECA, CALIFORNIA 95336 • GENERATING FACILITY (209) 982-4298 PHONE T: / V, (209) 982- 1009 FAX E NOTES: TRUCK NUMBER L-(U ADDRESS lj-4(�4k, CITY,S�TAT�ZIPv 1 �4 PHE END UMP BOTTOM DUMP TRANSFER �N ' - 'JJ ❑ ❑ SIGNATUR F. QRIZED AGENT OR DRIVER DATE ROL - FF(S) FLAT-BED VAN !`DRUMS FORWARD INC. LANDFILL CUBIC YARDS r, [FREMARKS orward shall have no obligation to accept the waste if weather or other ns impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) the safe and effective operation of the Landfill. Forward shall use DISPOSE BIO AERATE STOCKPILE OTHER ble efforts to promptly notify Disposer of its inability to accept the -_. for any reason. If Forward's refusal to accept the waste is based on SOIL r or other site conditions, Forward shall notify the Disposer when site ns are expected to change such that Forward will be able to accept te. ❑ SLUDGE KS - NON-FRIABLE ❑ ASBESTOS Y TICKET NUMBER ❑ WOOD URE OF AUTHORIZED AGENT DATE ❑ ASH /i p / �r ( C �/, ❑ OTHER HEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE EJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. TO SCHEDULE CALL (209) 982-4298 MANIFEST # 4920 7 'I