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NON—HAZ OUS WASTE MANIFEST <br /> , 3 ARD WASTE TRE ENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE NO. <br /> NERATOR UIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GLOVES [—]GOGGLES [-]RESPIRATOR []HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [—]OTHER <br /> E, ZIP J T j�f 1Y SPECIAL HANDLING PROCEDURES: <br /> CITY/STAT <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> SLUDGE <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> RIM_E NOTES: TRUCK NUMBER <br /> . CITY, STATE, ZIP <br /> PHONE EN MP BOTTOM DUMP TRANSFER <br /> ❑ ❑ <br /> SIGNATURE OF AUTHORIZED.AGENT OR DRIVER DATE ROL -OFF(S) FLAT-BED VAN DRUMS <br /> * y ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc YARDS . . <br /> Forward shall have no obligation to accept the waste if weather or other ' <br /> r conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLE DtBYFORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use ..+b .„ <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO �Aff1AEF_: Sf(1jif�,IIzE- 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 lQ <br /> conditions are expected to 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 /> NATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> c2 LlI f 'f '/ , P —/ Y �( ❑ OTHER <br /> CHEDUUNG MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> UBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL.THE DAY BEFORE. <br /> O SCHEDULE CALL (209) 982-4298 49206 <br /> MANIFEST # <br />