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ffWARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> r. JOB ACCF-F 1ANCE NO. �^ 93 -- 54Lt - - - -- <br /> NERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT - <br /> J?t ver,31de (;p-fr1prlt (;cmt))1r)y ❑GLOVES ❑GOGGLES ❑RESPIRATOR ®HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> I'.U. Pox 4r1()/t <br /> SPECIAL HANDLING PROCEDURES <br /> CITY, STATE, ZIP <br /> (,t�r lr�nci )',a r, ( A. r)170") C,�Q <br /> PHONE <br /> r, �F <br /> ra CONTAC �EON�6n <br /> ]" Jr'',1I1 F1)1USZR <br /> S <br /> SIGNATUBE IZED AGENT / TITLE DATE <br /> t ZA� <br /> tz WASTE TYPE RECEIVING FACILITY <br /> r <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1 fiiversvle COMPnt (,.0-p-,my (209) 982- 1009 FAX <br /> A <br /> ME NOTES TRUCK NUMBER <br /> JLnt Ihorl)e 01) , Inc. <br /> ? ADDRESS a-Pc <br /> F <br /> f'.t). Itc)y 357 <br />!' CITY, STATE, ZIP " <br /> r` <br /> I,()eILr r,A 95241-0 5( <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 74, <br /> r - SIGNATURE OF AUTHORIZED AGENT OR DRIVER DrA�TE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> " <br /> J � <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> �r Forward shall have no obligation to accept the waste If weather or other 1`` <br /> a 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 /> 111 reasonable efforts to promptly notify Disposer of Its Inability to accept the DISPOSE BIO AERATE STOCKPILE ';OTIf!*)t <br /> waste for any reason If Forwards refusal to accept the waste Is based on <br /> t� 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 /> +t REMARKS <br /> ❑ NON-FRIABLE <br /> _ <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATUR OF AUT ORIZED AGENT i DATE t <br /> [] ASH <br /> OTHER <br /> r+ 1III(, Mt)^.T r)f- I`AA111- rlTlnn Iii Ifvi 1, r'I 1111 f)AY r'T'IfW 1() t YVI'( IFI) AI1171VAf ANY UNSCIIEDULED LOADS ARC <br /> nI'It rr-t t t fl r'r FI IgAI I rf"It t A01+1 01 I)r rr (11,V, i 11\11 Ne i)I 11xrt I'ir ` f 9t t,;I I'r r'( I it DI It r 1) WI t I I I I IE LANDFILL I I IF_ DAY BEFORE <br /> It) V( IIT Ir1f1 F C AtJ ( 7On) n'7: I In 7874 <br /> MANIFEST # <br /> Irtnr� r111- , <br />