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4W "- NON-HAZAF US WASTE MANIFEST <br /> ARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> L INE. JOB ACCEPTAMAO. <br /> GEN, � R _ <• REQUIRED PERSONAL PROTECTIVE EQUIPMENT i <br /> ,.._ A1Cf{eT� �it/C1 ®GLOVES ❑GOGGLES ❑RESPIRATOR [OHARDHAT <br /> MAILING ADDRESS ❑TY-VEK []OTHER <br /> C 33- X ' ce- J " SPECIAL HANDLING PROCEDURES: <br /> CITY:STATE,ZIP <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 /> E] CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> EFwr�NAclury : �r (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX . <br /> Cr1VC,.qC-7 e— __7Z:/VC-, <br /> NAME: l., �� �n : k..,._.. .. s..;>•r.,t> NOTES: , ,,t�: , � Fes%-TRUCK NUMBER, <br /> •C..4v .'i f ._�.RJ.4rAww:^a�.�{t...� 4 �.,ys�_.,...:. <br /> ADDRESS F r y r 3 s , i' r <br /> { <br /> �. CITY,STATE, <br /> END DUMP }` BOTTOM DUMP TRANSFER <br /> �ti�_ J �v" .... .. ., a»u+� ..;c.:- _.....ti.r.rt..t .,.... •'., . �v r, 1 t- ��'�r•J' ,� ,''ti.�' <br /> SIGNATU E OF UTHORIZED AGENT OR DRIVER DATE RQLL-OFFS FLAT 13ED6„�. ;VAN ,DRUMS • - <br /> FORWARD INC. LANDFILLcuBierAs �p <br /> Forward shalt 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 F DISPOSAL METHOD , TO BE:COMPLETED BY.FORWARD} <br /> impairs the safe and effective operation of the andfill, Forward shall use !s , i�E Y <br /> reasonable efforts to promptly notify Disposer of'its inability to accept the _ „` t a:`�;� DISPOSE BIO RATE STOCKALE' OTHER <br /> waste for any reason. If Forward's refusal to'accept the waste is based on <br /> ._.. .. . <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 /> i `;"�:`•`.".-.,z?�'z �y;?r .r 4+Jr.�.., "3. '+'+�+'^r yFE�r'�p�;7'.Y:w.-'r'=fi" , <br /> REIvIARKB,: Y'T'aT �,, ��x = -.V]F1.�) <br /> ❑ NON-FRIABLE <br /> TICKET ASBESTOS <br /> FAClL1TY:;,.... _yNuLfNISEFi' • �`'�'' �� <br /> i ❑ WOOD <br /> SIGNATUREOFAUTHORI <br /> " �. ❑ ASH <br /> �, - [. r- / _) L ❑ OTHER <br /> NEDULINC JIUST 3E MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL � ANY UNSCHEDULED ED LOADS ARE <br /> _ }r .." - •trr,';rr_p .II _r '.f- a :- •r}—'.: - _ __ _ <br /> r tn• rr^cam - .. <br />