Laserfiche WebLink
FORWARIJ NON-HA DOUS WASTE MANIFEST <br /> INCORPORAFED WASTE TRE�iTMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. ►�►�_ <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 3toc]dott Pebole m Co[q mw _` _ GLOVES ❑GOGGLES [:]RESPIRATOR HARD HAT I <br /> `MAILING ADDRESS _ �; - - TY VEK ❑OTHER <br /> CITY, <br /> SPECIAL HANDLING PROCEDURES � <br /> ,STATE,ZIP <br /> • .PHONE �CE�.$5206 <br /> ((2092�7D7 _ <br /> CONTACT PERSON - <br /> SIGTA�UR AUTHORIZED AGENT / TITLE DATE <br /> WA5TE YPE RECEIVING FACILITY <br /> ❑ SLUDGE f <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL f <br /> • DISPOSAL SOIL ❑ WOOD <br /> CONSTRUCTION SOI. ❑❑ OTHER 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE ` MANTECA, CALIFORNIA 95336 <br /> F <br /> g,ENEWR7 GFACILITY W- - - _ - (209) 982-4298 PHONE <br /> 3300 West Low,Stocktce,CA <br /> (209) 982- 1009 FAX <br /> TRACTOR LIC # <br /> _ ,� { { �5 TRUCK NUMBER <br /> IQ a <br /> "RAILER LIC # �j" <br /> • CITY,STATF,,ZFF? TRAILER LIC # <br /> PHONE__,„� _w END DUMP BOTTOM DUMP TRANSFER <br /> O- <br /> IG _ TURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(5) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS - Y <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 ETHOD <br /> impairs the safe and effective operation of the Landfill Forward shall use ( E CQMPLETED BY FORWARD) <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE RIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on I <br /> weather or other site conditions, Forward shall notify the Disposer when sit S L <br /> • conditions are expected to change such that Forward will be able to accept I <br /> s the waste -- _ _ _ _ _ ❑ SLUDGE <br /> REMARKS � 1 <br /> FACILITY—TICKET NUM_--B-ER_ 'r--- ❑❑ NON-FRIABLE <br /> ASBESTOS <br /> WOOD <br /> SIG-NATUTHORIZ DA DATE ASH� <br /> I <br /> OTHER <br /> SCHEDULING MUST BE MADE PR R TO 4 OQ P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVA G DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE i <br /> TO SCHEDULE CALL(209)982-4298 GENERATOR COPY 624665 <br /> F01{C9511NH)6-96 a MANIFEST # C <br />