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ell FORWARD NON-HA IDOUS WASTE MANIFEST <br /> V� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. ; 4 ` <br /> GENERATOR a� _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> >.-•r ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS .. �' "s;; ❑TY-VEK [—]OTHER <br /> STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> CITY <br /> PHONEval <br /> CO<JTACT PERSON f �3L <br /> J�� <br /> SIGNATURE Or AUTHORIZED AGENT/ TITLE DATE <br /> f <br /> WASTE TYPE RECEIVING FACILRY , <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> El CONSTRUCTION SOIL ❑ ASH ASH <br /> " '❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATING FACILITY R - st .;,. (209) 982-4298 PHONE <br /> j/.•5' (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> ADDRESS <br /> • CITY,STATE,ZIP <br /> # '_ _. <br /> PHONE �;: .'END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED A&ENT,OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL <br /> CUBIC <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 - p <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE 810 AERATE JsTowu OTHER_��!• <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 ❑ SUIL <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 /> FACILITY TICKET NUMBER <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 ? n <br /> MANIFEST # �J <br /> GENERATOR COPY <br />