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t . rUKVYAK NON-HAZARDOUS WASTE MANIFEST <br /> J NCO R POR ;ATE WASTE TREI�ENT AND DISPOSAL FACILITY <br /> JOS ACCEPTANCE N4, E771811 <br /> GENERATOR , REQUIRED PERSONAL PROTECTIVE EQUIPMENT s <br /> ]true AN-FSK&EWy bdmt GLOVES ❑GOGGLES ❑RESPIRATOR [SHARD HAT - <br /> AWRESS ❑TY VEK ❑OTHER <br /> la8dt)Goc�dym Ramd . <br /> STATE;ZIP` SPECIAL HANDLING PROCEDURES: <br /> BmicstCA 94520 <br /> 743-2955 <br /> PERSON <br /> iU. <br /> AUT <br /> )"IZEgNT DATE <br /> ,,9` �V_T1 <br /> TYPE <br /> 3 RECEMNG FACILITY.,';; <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> `GENERATINGFACILITY (209) 982-4298 PHONE <br /> 249 X=11mdb* `ry <br /> � >�: (209) 982- 1009 FAX <br /> E TRA J TRUCK NUMBER <br /> Di)Ia�3 �1 scm.-i= .�� <br /> ADDRESS TRA RELIC. <br /> Past Offen Box$79 /i� p 5- 797. <br /> CITY,STATE,ZIP TRAILER LIC.# <br /> 13�'rcx%CA!�45 14 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ,SIGNATURE OFA U*OF)UAD AGENT OR DRIVER DATE ROLL-0FF(S) . FLAT=BED VAN DRUMS` <br /> -71ce`= <br /> 'r <br /> FORWARD-INC. LANDFILL CUBIK <br /> IC 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 STOCKPLE 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 acce <br /> the waste. ❑ SLUDGE <br /> .REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY TICK T NUMBER ASBESTOS <br /> ❑ WOOD <br /> SIGNATUPf AUTHORIADIAGENT <br /> Fb <br /> E <br /> I r"� l !' ❑ 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 DAY BEFORE. <br /> TO SCHEDULECALL(209)982-4288 J r <br /> 8 <br />