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' NON-HAZARDOUS WASTE MANIFEST <br /> fORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> IMC_ JOB ACCEPTANCE N0. <br /> GEN BATOR _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GLOVES GGLES ❑RESPIRATOR -PHARD HAT <br /> !LING ADDRESS - [:]TY-VEK E30THER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> • S�����.�� .-cam,-__ s�s�� <br /> PHONE_ <br />' CONTACT PERSON'. <br /> SIGI: <br /> NAT AUTHO ZED &QENT/ TITLE DATE <br />' , — - v✓ <br /> RECEIVING FACILITY - <br />' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • L3-DISPOSAL SOIL E3 WOOD <br /> ❑ CONSTRUCTION SOIL E] ASH <br /> 9999 SOUTH AUSTIN ROAD <br />' ❑ OTHER MANTECA,-CA. L1FORN]A 95336 <br /> GENERATING FACILITY (209) 98 2-4298 PHONE <br /> T'+ <br /> ;y; ��r, s.•� 3,�,��.; (209 982- 1009 FAX <br /> k- <br /> !5 �� c� r f.2ru 7 <br /> NAME NOTES: TRACK NUMBER, - <br /> ADDRESS <br /> k • CITY,STATE,ZIP" c2 <br /> PHONE T END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATU OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT=BED VAN DRUMS` <br /> `1 FORWARD INC. LANDFILL cuBlc YARDS <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 HOD: (T(yBE 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_T_1CKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> - SIGNATURE OF AUTHORIZED AGENT — DATA <br /> DASH <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 <br /> BEFORE- <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # 14561 <br /> GENERATOR COPY <br />