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' NON-HAZARDOUS WASTE MANIFEST <br /> WARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. [-5�3 S-S <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MAILING!©_-AFBs CL L - - E]TY-OVEKS ❑OTONER GGLES [:]RESPIRATOR SOARD HAT <br /> 60ro- SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP __ _ _ -_ _ _ _ _ __. <br /> • sA � c,q - <br /> - .PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED A T/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY _ -- <br />' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ woo- 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> '• ❑ OTHER MANTECA, CALIFORNIA 95336 . <br /> • <br /> GENERATINGFACIUTY (209) 982-4298 PHONE <br /> 39`'�'` X (209) 982- 1009 FAX <br /> 3 5 ,vac r c sati SOA& +:w/ <br /> dc/rfad <br /> (NAME NOTES_ TRUCK NUMBER <br /> ADDRES�St vfJ�P•Ci.9/ <br /> o <br /> . • <br /> a 3 3 ,Ud9.ji C4,eDiN4r <br /> • CITY,STATE,ZIP <br /> STvcXtv,r r 5'sa05 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 4& _ ❑ ❑ ®— . <br /> SIGNATURE OF AUTHORIZED AGENT OR-DRIVER DATE ROLL-OFFS) FLAT-BED VAN - DRUMS.- <br /> . * / .f - EN ❑._ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS . <br /> Forward shall have no obligation to accept the waste if weather or other - 0 <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 Landfill. Forward shall use - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE SCOCKRLE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on ❑ 501E <br /> weather or other site conditions, Forward shall notify the Disposer when site <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 /> 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 14565 <br /> ORE <br /> TO SCHEDULE CALL(209)982-4298 <br /> MANIFEST# <br /> t GENERATOR COPY <br />