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FORWAI NON-HAZ OUS WASTE MANIFEST <br /> I N WASTE TRENT AND DISPOSAL FACILITY <br /> C O Ft,�P O R�A T E l <br /> r s1 <br /> JOB ACCEPTANCE NO. 64 ' 1`f <br /> ENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT 1 <br /> Stock#an Pt" Compemy RGLOVES ❑GOGGLES ❑RESPIRATORS HARD HAT <br /> MAILING ADDRESS_ - -- ❑TY-VEK [:]OTHER <br /> SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZIp -- -- --- <br /> • PHS HONE_ - - - - - -- - -- <br /> _ _ , <br /> O CT PERSON , } <br /> MCMzdL_ <br /> SIGNATURE AUTHORIZED AGENT /TITLE-� - DATE <br /> WASTETYPE' RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DISPOSAL SOIL ❑ WOOD <br /> CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ <br /> STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> aIwNERATNG�AGILITY_ L , _ 4 (209) 982-4298 PHONE <br /> 3300 went,lar,Stodda%CA � <br /> (209) 982- 1009 FAX <br /> i <br /> AME _ A -=� _ µ - 'rfgC70R LIG # TRUCK NUMBER <br /> ADDRESS - ---_-_ - __ TRAILER LIC # - <br /> -3 <br /> . CITY, 7ATE, ZIP_ _ _ _ _ TRAILER LIG # <br /> pMO� �"' END DUMP BOTTOM DUMP TRANSFER <br /> . '81GI�VA I <br /> - * WGNT,OdAQRIVE DATE ROLL❑- FLAT-BED �VAN - DRUMS_ -" <br /> ❑ ❑ o <br /> 4� <br /> _ «a _•,� CUYARDS <br /> FORWARD,INC.LAN. DFILL - <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 ME 4T0 BE COI�IPLETE�BY FORWARD) l <br /> impairs the safe land effective operation of the Landfill Forward shall use o <br /> reasonable efforts to promptly notify Disposer of its inability to accept the f ISF?OSE 810 _ AEMTE STOCKPLi 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 <br /> - conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • -REMARKS T ----__��,—_,�__�_...____ _ _ <br /> NON-FRIABLE <br /> ,-_FAC_ILI___�_ NU._E M <br /> , wBE - <br /> ❑ ASBESTOS <br /> TY T <br /> .�_ _ `_ .�_.._ �. --- _— --- -- ❑ WOOD 1' <br /> SIGNAT FIE D AU R ED A NT D _ -- F <br /> ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MAD R TO 4 OO 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 GENERATOR COPY <br /> F01(C951INH)6 00 MANIFEST # C 624677 <br />