Laserfiche WebLink
�e1i FORWARIN NON-HA; 3DOUS WASTE MANIFEST <br /> V� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. l ` <br /> GENERATOR „ _.x; REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> [I GLOVES El GOGGLES <br /> ]RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESSacj;. ❑TY-VEK El OTHER <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> a* .. <br /> • PHONE <br /> L <br /> CONTACT PERSON ` <br /> SIGNATURE OF AUTHORIZED AGENT/TITLEC <br /> DATE <br /> i <br /> • WASTE TYPE _j` RECEIVING FACILJTY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • ., (209) 982-4298 PHONE <br /> GENERATING FACILITY <br /> { ` (209) 982- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER a,'_ <br /> ADDRESSn ��Re3�.'; <br /> • CITY,STATE,ZIP <br /> PHONE A `a3 T M '<n''' END DUMP BOTTOM DUMP TRANSFER• . <br /> El ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc YARDS h. <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 FORW RDW <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( OTHEff( <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 /> conditions are expected to change such that Forward will be able to accept <br /> • <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> • . .... <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 # - i 1 (� <br /> GENERATOR COPY <br />