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jIZWA <br /> RD <br /> 14-HAZARDOUS WASTE MANIFEST <br /> ! N C O R P O R A T F D WASTE TRD, <br /> EATMENT AND DISPOSAL FACILITY So, <br /> JOB ACCEPTANCE NO. <br /> -d <br /> lt- - <br /> GENERA,TOFt f �. , # r t. t !„ g REQUIRED PERSONAL PROTECTIVE EOUIPME�NT <br /> Lit r 1 �� �� ) , , t j ! j _ Q GLOVES [:]GOGGLES F]RESPIRATOR �,D HARD HAT <br /> MAILING ADDRESS_' t J _ '� f ° ; ' f; ❑TY-VEK ❑OTHER i <br /> CITY,1sTATE,ZIP `' ""' SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATUF&OF�AUTH6RIZED AGENT I TITLE I� DATE <br /> � I <br /> WASTE TYPE _ t RECEIVING FACILITY_': t <br /> I <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> w ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> Fl CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> w <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME i , - r ' - r NOTES,-,. ,_ TRUCK NUMBER <br /> ADDI3E�$ N <br /> CITY,igtATE,Z!P r• `i -_ - . ff _ aJC••�I C: (JTx I—1 <br /> PHONiE`_�^ _ _ �-1 ." END D MP -BOTTOM DUMP TRANSFER <br /> El 11 <br /> s� { - m w �' -R� -OFF(S) r ? F LA7 8ED VAN DRUMS <br /> SIGNAT AUTHORIZED AG NT OR DRIVER - DATE h_ ; <br /> FORWARD-INC. LANDFILL CUBIG,Y,,RDs • t�� <br /> Forward shall have no obligation to accept the waste if weather or other 11 I <br /> conditions impair the safe and effective disposal of the waste or if the waste ,DISPOSAL METHOD,{" <br /> ,� (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill forward shall use '�I �t � � rte � I <br /> reasonable efforts to promptly notify Disposer of its inability to accept the ��; D�$f?pS l 03 1111 AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site � SOIL l <br /> conditions are expected to change such that Forward will be able to accept <br /> • the waste _ ❑ SLUDGE <br /> REMARKS - �- K�_: . •� y� y- t K <br /> NON-FRIABLE: <br /> TI r7 ASBESTOS I <br /> FACILITYCKET NUMBER;,w=:. _ r ti=� <br /> v3 i <br /> ❑ WOOD <br /> SIGNATURE OF At'J RtZED AGEN7;izDATA/4,_ <br /> _: I <br /> ❑ ASH <br /> C ❑ 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 t <br /> MANIFEST # 80020 <br /> f1A4im SOFY <br /> E <br />