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�nv�AR� NON-HAZP RDOUS WASTE MANIFEST INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE NO. / GEN�TOR i _� I REQUIRED PERSONAL PROTECTIVE EQUIPMENT j" ❑GLOVES ❑GOGGLES ❑RESPIRATOR C]HARD HAT MALING ADDRESS CITY-VEK ❑OTHER `— SPECIAL HANDLING PROCEDURES: CITY,STATE,ZIP PHONE 's, ' COCN:9,CT-RERS0N r SIGNATdREQF AUT!•I0Fj gEa ,GENT/ TM—E DATE _ " k ? • WASTE TYPE RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL • [ -CONST CONSTRUCTION ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ASH ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATINGFACILm (209) 982-4298 PHONE (209) 982- 1009 FAX NA,IFA,)E NOTES: TRUCK NUMBER CITY,SLATE,ZIP • PHONE y l END❑DUMP BOTTOM DU — TRANSFER SIGNATURE OF AUTHORIZED AGENT 90�. VER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS r ❑ ❑ ❑ ❑ FORWARD INC. LANDFILL CUBIC YARDS ( • { UU r �.. Forward shall have no obligation to accept the waste if weather or other �•- --- conditions impair the safe and effective disposal of the waste or rf the waste DISPOSAL METHOD: 8E COMPLETED BY FORNWRD impairs the safe and effective operation of the Landfill. Forward shall use ) reasonable efforts to promptly notify Disposer of its inability to accept the NPOSE BIO AERATE STOCKPILE OTHER waste for any reason. It Forward's refusal to accept the waste is based on 'E weather or other site conditions, Forward shall notify the Disposer when site L'I SIL I�_ � conditions are expected to change such that Forward will be able to accept the waste. ❑ SLUDGE • REMARKS ❑ NON-FRIABLE FACILLTY'ITICKET NUMBER ASBESTOS ❑ WOOD SIGNATURE OF AUTHORIZED AGENT " DATE_ , ❑ ASH ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE- TO SCHEDULE CALL (209) 982-4298 C--_ r,r 3 - MANIFEST M _ � ,: