Laserfiche WebLink
'L <br />®�NON-H RDOUS WASTE MANIFEST <br />® r INCORPORATED o WASTE TREATMENT AND DISPOSAL FACILITY <br />j� JOB ACCEPTANCE NO,- <br />GENERATOR REQUIRED PERSbNALPROTECTIVE.EQUIPMENT_ <br />._ <br />L•.v- ; z f ;� ; S ❑ GLOVES ® GOGGLES ❑ RESPIRATOR ❑ HARD HAT <br />MAILING ADDRESS k ❑ TY-VEK ❑ OTHER <br />CITY, STATE, ZIPS ` ;'//a.e <br />SPECIAL HANDLING PROCEDURES: <br />t t-YYl 6�1 tT , <br />PHONE �x z� <br />CON7ACTP.ERON <br />-,..a) _i,j <br />SIGNATURE 0(,THORIZErAGE '/ TTL DATE, <br />, <br />® WASTEPE , <br />- y..k TY <br />RECEIVING <br />❑ SLUDGE <br />❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL <br />* ❑ DISPOSAL SOIL ❑ WOOD <br />❑ CONSTRUCTION SOIL ❑ ASH 9999. SOUTH AUSTIN ROAD- <br />" ❑ OTHER ANTECA, CALIFORNIA 95336 <br />:GENERATING FACILITY' (2®9) 982-4298 PHONE <br />r:Lm�wrr 75r (209) 982-1009 FAX <br />ST:;°r<Sz:>r­ C <br />• E """ �.:�a` � �� i<" �;.,�..:7 a,�,�m � ' r,�" �.. ...� �Nt3TES r � � ^t� �' 7RUCKNUMBER�x <br />T A DR 7�njiJ�.+iL <br />.a.,...:..y_�"^ter"�a.. ki k ...: .. x. ... � wo..4 �;.w.....:.u�w .. e: ! ^}''� ^'� ✓ /� f <br />• GITY� STATE, ZIP '. _ , ?, ., . • i � f� '� � � .y j � "� .'"" "? <br />PHONE>,£s _END DUMP _,� BOTTOM DUMP TRANSFER <br />�.3C 1�°lJ? �� ❑ ❑ <br />SIGNAT(1RE OF AUTHORIZED AGENT OR DRIVE ' DATEROLLOFF(S)E FLAT BEDS VAN DRUMS; <br />El 11 <br />i �im <br />INC. LANDFILL <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 BE COMPLETED BY FORWARD) j <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 A- �°' DISPOSE rhe BIO � AERATE ST t E OTHER ' <br />waste for any reason. If Forward's refusal to accept the waste is based on m �A- <br />weather or other site conditions, Forward shall notify the Disposer when sit SOIL <br />conditions are expected to change, such that Forward will be able to accep <br />the waste. ❑ SLUDGE <br />NON -FRIABLE <br />FACILITtjTICKET UMBER e ASBESTOS <br />❑ WOOD <br />SIG A URElkTHORIZED '"" T <br />"'� c _ . (� ❑ ASH <br />G ❑ 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 />TO SCHEDULE CALL (209) 982-4298 MANIFEST # 73175 <br />SALES COPY <br />