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tAZ <br /> WARD �'" Y.:.WASTE TRE '(ENT AND DISPOSAL FACILITY <br /> r JOB ACCEPTANCE , ' <br /> t� <br /> �; .: <br /> GEICfERATQ,„ -` BEGURE`F RS I�fAE FROMen-w-II; Ueimo a „ <br /> � <br /> PRQDOQTI []GLOVES []GOGGLES []RESPIRATOR ❑HARD HAT <br /> MA(L`IN�AQDRESS�< � °�" " ' � `, ~�', f' '.;❑TY-VEK �El OTHER . <br /> __ 1QOOE. C; AtN . <br /> SPECIAL HANDLING PROCEDURES: . <br /> • _STOCKTON x. CA 852tfS <br /> 209-943-7.337 <br /> CONTACT PERSON' frL707271w '- <br /> PHIL BOLER . <br /> SIGNATURE OF AUTHORIZED AGE17�. r ' <br /> Adz <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> F1 TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ® DISPOSAL solL ❑ 99990SOU'TH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> .. ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • <br /> GENERATING FACIL,,Y 1V (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> RICH HAMILTON TRUCKI4G <br /> ADDRESS C `� <br /> 1336 PAULINE AVE . LOAD #5 <br /> . CITY,STATE,ZIP <br /> MODESTO, CA 95351 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 � ❑ ❑ <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 8 <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 STOCKPILE' OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based onSOIL <br /> weather 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 /> REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILIT)JICKET NUMBER <br /> . ` ❑ WOOD <br /> SIGNA URE`,OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> \ / <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 DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 1 TRANSPORTER COPY MANIFEST# C 5 4 9 2 <br />