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FORWARD �- NON-HAZARI,,US WASTE MANIFEST <br /> i <br /> ►"a INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 4J�Or �. c$�oA <br /> []GLOVES []GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS <br /> J [_]TY-VEK ❑OTHER <br /> oI 9 t/ SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP " <br /> PHONE <br /> X09 6 69 .7 <br /> CONTACT P R ON <br /> /V/, " "A r-+ a j <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> • WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ' p 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 1 NOTES: TRUCK NUMBER <br /> / <br /> ADDRE96 J <br /> � <br /> �'I0Ow. Nwy 1a � �✓ <br /> • CITY, STATE, ZIP <br /> • Cod, Lc1 7.5o24;, <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> T ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> J .. /��-1 ❑ ❑ ❑ ❑ <br /> �k .� ..�'-�-fir✓ �.� � ,, <br /> FORWARD INC. LANDFILL CUBICYARD <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 <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DIYPOSE 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 0 <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> s <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE F UTHORIZEDA ENT PAT I` / Q��/ <br /> ❑ ASH <br /> \J_ �'�- �{ `��,,'� I_J ❑ 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 DAY BEFORE. <br /> TO SCHEDULE CALL (209)982-4298 091365 <br /> MANIFEST # <br />