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NOWH ` DOUS_;WASTE MANIPiST <br /> WARD WASTE T, AND DISPOSAL rxiEM* <br /> INC JOB ACCEPTANCE <br /> 3 <br /> NO. -� <br /> GENERATOR,_ <br /> REQUIRED P PRQTI=CTIVE_EQUIPMENT <br /> GLOVES ❑GOGGLES []RESPIRATORARDHAT <br /> MAILING AD_DRE ❑TY-VE K []OTHER <br /> tP _ E o S'c) <br /> CITY,STATE,ZIP — SPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT PERSON <br /> SIGN;4TURE OF A_U_T_H0___ <br /> �R!ZFA AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br />' ❑ TREATMENT SOIL ❑ NON-FRIABLE-ASBESTOS FORWARD INC: LANDFILL, <br /> • aDISPOSAL SOIL Q-WOOD 11 <br /> ' ! r� <br /> ❑ CONSTRUCTION SOIL ❑ ASH `��~. 9999 SQLjTH-A8TIN ROAD <br /> " ❑ OTHER -- ^ <br /> �- - MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY <br /> - 209 982-4298 PHONE. <br /> Noe r,Hsf1 srJA r (209 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> ADDRESS <br /> . • Z33 ^loefN c4e0; Js?L jq.v% ! <br /> • CITY,STATE,ZIP <br /> . PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNAT OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> .� 9- ❑ ❑ ❑ ❑ <br /> l� <br /> F <br /> FORWARD INC. NDFILL CUBIC YARDINC. <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 IYE 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 BIO 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-FRIABLE <br /> FACILITY TICKET NUMBER- - - - ❑ ASBESTOS <br /> _ - — --- — ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <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 /> Yo SCHEDULE CALL (209)982.4298 MANIFEST # 14546 <br /> GENERATOR COPY <br />