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NON-HAZ 70US WA5It MANIt-t5I <br /> F—WWARD <br /> WASTE TRE `RENT AND DISPOSAL FACILITY <br /> la JOB ACCEPTANCE N0. � � <br /> C � ; a <br /> o - 60isw t.. <br /> GENERTOEtr, _Rs '" � * _IEQUIR�D-PERSdNALn ?QITEGIl1PliEl ?#— `_.. <br /> DC]GLOVES. ❑GOGGLES []RESPIRATOR E]HARD HAT <br /> MAILPID7 � ❑TY-VEK []OTHER <br /> a 4 <br /> SPECIAL HANDLING PROCEDURES: <br /> TE <br /> • STQKCITI � G�1� Q5? 5 �, <br /> aux <br /> { <br /> PHONE 573 �` sr...n77,t'� <br /> 209-943,133,71--l'-1. -- , <br /> CONTACT PERSON <br /> PHIL- 8O.LER. .. �. <br /> SIGNATURE OF AUTHORIZED AGENT Y TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY r <br /> ❑ SLUDGE <br /> ❑ 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 NOTES: TRUCK NUMBER <br /> RICH HAMILTON TRUCKING <br /> ADDRESSf <br /> 1336 PAULINE AVE . LOAD #4 <br /> . CITY,STATE,ZIP <br /> MODESTO, CA 95351 <br /> • PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-578-4100 ❑ ❑ <br /> SIGNATURE OF AUTHORISED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <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 COMPLETEL 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 OIL <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 wraste. ❑ SLUDGE <br /> • REMARKS f <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGN RE OF AUTHORIZED AGENTDATE <br /> _ ❑ ASH <br /> l a ❑ 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 /> TRANSPORTER COPY MANIFEST# C 5491 <br />