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�A FORWARIP. NON-HAZ OOUS WASTE MANIFEST � <br /> V� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. }: — <br /> GENERATOR 7TE7777 REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> E]GLOVES ❑GOGGLES ❑RESPIRATOR El HARD HAT <br /> MAILING ADDRESS ' j - ... ❑TY-VEK ❑OTHER <br /> CITY,STATE, ZIPfiLG*a <br /> SPECIAL HANDLING PROCEDURES: <br /> r �re1 <br /> PHONE ."yV <br /> CONTACT PERSON ° ,. <br /> - r <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE-,- j" DATE <br /> WASTE TYPE ' RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> [j CONSTRUCTION SOIL ❑ ASH ASH <br /> .❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY (209) 982-0298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME -.,;', NOTES: ".TRUCK,NUMB <br /> r <br /> ADDRESS �a � '� <br /> 8. r4� x9`ai'SL.i, x <br /> t, <br /> • CITY',STATE,ZIP n <br /> • PHONE 'S END DUMP BOTTOM DUMP <br /> :w <br /> :❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS rt <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc 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 FORWARp <br /> impairs the sate and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the IDISPOSEI BIO AERATE(STOCKPILE OTHEF; n <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 SOIL <br /> weather <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS <br /> ' ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER " ASBESTOS <br /> „. ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE / <br /> ❑ 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 SCHEDULE CALL(209)982-4298 MANIFEST # � % ') ,3 13 O ^.,:.f <br /> GENERATORCOPY � <br />