Laserfiche WebLink
I N C O R P O R A T E P, WASTE TREATMENT AND DISPOSAL FACILITY ' <br /> f JOB ACPTANCE N0. Na � <br /> Effll <br /> 4 <br /> f GENERATOR <br /> RE9ARED PERSONAL PROTECTIVE EQUIPMENT •�.. <br /> aGLOVES ❑GOGGLES El RESPIRATOR gHARDHAT k <br /> MAILIN DDRESSg - <br /> r . 3 ❑7Y-VEK ❑p OTHER <br /> C ! # ' ' � r SPECIAL'I HANDLING PROCEDURES: <br /> ITY, STATE, ZIP��' <br /> PHONE <br /> s: <br /> 73-) 7 I <br /> CONTACT PERSON' <br /> y: <br /> 'I <br /> i <br /> SIGNATURE OF AUT!�O E G •NT/ T[lLE DATE - !j! <br /> WASTE TYPE , RECEIVING FACILITY <br /> I� <br /> - I <br /> ❑ SLUDGE �{ <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> - • ❑, DISPOSAL 501E El WOOD Ir <br /> CONSTRUCTION SOIL E] ASH 9999SOUTH AUSTIN ROAD <br /> I� <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> y <br /> 'GENERATING FACILITY - -. , }(209) 982-4298 PHONE <br /> 7: -f '!, _ ��c ,::_ -, : , I (209) 982- 1009 FAX <br /> NAME NOTES_$ i ,� TRUCK NUMBER <br /> ADDRESS <br /> . CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER r <br /> E ❑ ❑ } <br /> SIGNATURE OF.AUTHORIZED AGENfOR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ 11 ❑ ❑ r <br /> n ITS Li"��' �^+�� •f•_ f., — Y i� <br /> CUBIC YARDS , <br /> FORWARD INC. LANDFILL ,r <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 <br /> 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 810 AERATE STOCKPILE OTHER <br /> ` .. <br /> waste �- <br /> for any reason. If Forward's refusal to accept the waste is based on 3f <br /> weather or other site conditions,Forward shall notify the Disposer when site ❑ SOIL <br /> conditions are expected to change such that Forward will be able to accept I !: <br /> the waste. SLUDGE <br /> • REMARKS . . �.. :: _ ❑ ,l <br /> • ❑ NON-FRIABLE ,� <br /> ASBESTOS <br /> FACILITY.TICKET WO <br /> MB a' <br /> ❑ WOOD <br /> SIGNATUREIOFt4UT4ORIZED#GENT � HATE <br /> a I ! ❑ ASH i{ <br /> I I «[[[[ ❑ OTHER II <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> F SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. t <br /> TO SCHEDULE CALL (209)982-4298 i <br /> MANIFEST # 57971 <br /> SALES COPY I{ <br /> -tr �� <br />