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FORWArD NOWHI -�RDOUS WASTE MANIFEST <br /> L,►� <br /> INCORPORATED WASTE 1 nEATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> (, -1 - r`ff � � ❑GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ' MAILING ADDRESS ❑TY-VEIC [:]OTHER <br /> ,r>a f SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZIP <br /> PHONE <br /> ' CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ' ❑ SLUDGE <br /> E] 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 /> (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> ADDRESS <br /> . CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ <br /> . SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ' FORWARD INC. LANDFILL CUBIC YARDS <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) <br /> ' impairs the safe and effective operation of the Landfill Forward shall use DISPOSE BIO AERATE ISTOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason If Forwards refusal to accept the waste is based on [:]-SOIL 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 /> • REMARKSNON-FRIABLE <br /> ❑ ASBESTOS <br /> ' FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT ,� DATE <br /> ❑ ASH <br /> 1 , <br /> G L f f`'`may—y� -� �, 1� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 OQ 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 LAN `DDFIL C AYBEFORE <br /> TO SCHEDULE CALL(209)982-4298 57825 <br /> GENERATOR COPY <br />