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dl/ARD NON-HAZ 'DOUS WASTE MANIFEST <br /> WASTE TR& ENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. c.Mt-0 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> .MAILING A R SS , J� � ❑TY-VEK [-]OTHER <br /> 1400 IY IG70,e (�4 / SPECIAL HANDLING PROCEDURES: <br /> CITY, STATE, ZIP <br /> • (-- <br /> 4 -' <br /> PHONE <br /> D /` " C 7 <br /> ' CONTACT PERSON_—G 3`?J <br /> SI N , OF AUTHORIZE GENT / TITLE DATE <br /> WA El"it"YPIE RECEIVING FACILITY _ <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL--_ > <br /> • p-CONSTRL SOITIO _ ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH , <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> ENERATIN(", FACILITY' _ (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> AME NOTES: TRUCK NJMBER <br /> A <br /> eDD SS <br /> - R- LJ j <br /> STATE,Z � <br /> O <br /> NNE � j END DUMP BOTTOM DUMP TP.ANSFER:'-- <br /> El El <br /> ,SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 ) <br /> reasonable efforts to promptly..notify Disposer of its inability to accept the DISPOSE BIO AERATE�STOCXPILFI 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 ❑ <br /> SOIL <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 /> SIONATUR (�AUTRI DIAGENT . ATE <br /> ❑ ASH <br /> *� - i Atom - 1 ❑ 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 <br /> MANIFEST# 154138 <br />