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., OR'�AR''� NON-HA RDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR RE UI D PERSONAL PROTECTIVE EQUIPME T <br /> s '�� GVOV <br /> LES [-]GOGGLES ❑RESPIRATOR HARD HAT <br /> *AE /�R `r*r�� au ) [:]TY-VEK ❑OTHER <br /> MAILING PDRESS. <br /> 2L�1D 5Yl/�1'S�.ri'r71'a� SPECIAL HANDLING PROCEDURES <br /> CITY,STATE.ZIP <br /> 5-to4klDrl1 C/? <br /> CS3o a -A54 <br /> CONPERSON <br /> ./ rrwir t <br /> SIG OF RIZED AGENT/TITLE DATE <br /> WASTE TYP RECEIVING FACILITY <br /> ❑ SLUDGE ------ FORWARD INC. LANDFILL <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE: AS9 <br /> • ❑ DISPQSAL SOIL ❑ WOOD 999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> ,. ❑ STOCK PILE OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FAGI <br /> (209) 982-4298 PHONE <br /> qC00 1 m5 )20aa (209) 982--1009 FAX <br /> CA - <br /> TRAILER uY10-PNAME J1 TRgCTO 1ADDR TFtUCK NJMBER <br /> `�`A'�(Z� * � � TRAILER UC&))C',5I r ?0 b g <br /> . CITY. �ZJ + �� �I L...1 r[� END MP BOTTOM DUMP TRANSFER <br /> PHONE V Q�hLa <br /> J ✓ D � ❑ ❑ <br /> AUTHORIZED AOR DRIVER LDAITE ROLL-OFFS) FLATBEDVAN DRUMS <br /> SIGNATURE.OFA ❑ ❑ ❑ ❑ <br /> � <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste of weather or other <br /> f� <br /> �t safe he effeeand eHeclive dop W of the Forwait rd the <br /> waste <br /> DISPOSAL METHOD (To BE COMPLETED BY FORWARD) <br /> mygmDISPOSE BIO AERATE sTOCKPu.E OTHER <br /> reasonable efforts to promptly notify DmPowr of its mab+ldy to accept the <br /> waste for any reason. h Forward's refusal to accept the waste is based on ❑ SOIL <br /> weather or other site conddrorm%Forward shall notify tete Disposer when site <br /> • conditions are expected to change such that Forward will be able to accept waste SLUDGE <br /> the ❑ <br /> REMARKS NON-FRABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER ❑ WOOD <br />. . SIGNATURE OF AUTHORIZED AGENT DATE ❑ ASH <br /> OTHER <br /> DS AF <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P.M THE DAY PRIOR 70 EXPECTED ARRIVAL • ANY UNSCHEDULED AY BE <br /> R <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH TILA ESTI CLL H 61 9 4 Q <br /> TO SCHEt E CALL(209)982-4298 GFNFRA70R COPY <br /> Fns W4511, ae <br />