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T1plE1Q/—p7Vp TJIJYVJ"R�FAUTE ITS-- <br /> JOB ACCEPTANCE NO. 579511'1' <br /> G�NERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 1 a c11 t E r IG -= - ❑GLOVES ❑GOGGLES [-IRESPIRATOR E]HARD HAT <br /> MAILING 14 DRESS ❑TY-VEK [_]OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY, STATE, ZIP _ - <br /> PHONE- / <br /> CONTACT PERSO}4 <br /> r— / <br /> IGNrPT. iE�F�U ORI / D AGENT/ TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • g--OSPOSALSOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATINGFACIILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAM,i{ _, NOTES: TRUCK NUMBER <br /> r;t I F e_ t c k'. rtGr < 1. <br /> ADDRESS <br /> CITY, STATE, ZIP <br /> C�- � S� <br /> PHONE END DUMP BOTTOM DU TRANSFER <br /> 33� </i 2- El ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDSr ^ <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: (T� C A TED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE 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 IL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATUFE,OF AUTHORIZED AGENT DATE , <br /> ❑ ASH <br /> * ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 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 DRAY BEFO'' <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST # 0 nC/ <br />