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NON -HAZE SOUS WASTE MANIFEST <br />Fr4left-w"WASTE TREATMENT AND DISPOSAL FACILITY <br />WARD <br />/NC. JOB ACCEPTANCE NO. <br />GENERATOR , ,, ,f <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />❑ GLOVES []GOGGLES ❑RESPIRATOR ]HARD HAT <br />MAILING ADDRFWS <br />❑ TY-VEK ❑ OTHER <br />- <br />r <br />SPECIAL HANDLING PROCEDURES: <br />CITY, STE. ZIP i <br />PHONE _ <br />CONTACfE�RSON ; <br />4 If •ire e_�J <br />SIGNATURE OF AUTHOrD AGENT / TITLE DATE <br />WASTE T'YPE'/ <br />RECEIVING FACILITY <br />❑ TREATMENT SOIL <br />❑ SLUDGE <br />❑ NON -FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />• © DISPOSAL SOIL <br />❑ WOOD <br />9999 SOUTH AUSTIN ROAD <br />❑ CONSTRUCTION SOIL <br />❑ ASH <br />' <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY ;r; ;. <br />(209) 982-1009 FAX <br />NAME <br />NOTES: _ .. TRUCK NUMBER <br />ADDRESS y% O 4 cA- <br />. • CITY, STATE. ZIP <br />• <br />PHONE 33y- add % : . <br />END DUMP BOTTOM DUMP TRANSFER <br />.-. <br />Cl <br />SIGNATURE OF AU O IZED AGENT OR DRIVER DATE <br />ROLL-OFF(S) FLAT-BED VAN DRUMS <br />El <br />FORWARD INC. LANDFILL <br />CUBIC YARDS12 <br />Forward shall have no obligation to accept the waste if weather or other <br />DISPOSAL METHOD: <br />(TO BE COMPLETED <br />BY <br />FORWARD) <br />conditions impair the safe and effective disposal of the waste or if the waste <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 <br />r .. _- __ _ <br />DISPOSE BIO., AERATE <br />ISTOCKPILE <br />OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />0 SOIL <br />weather or other site conditions, Forward shall notify the Disposer when site <br />/ <br />' conditions are expected to change such that Forward will be able to accept <br />the waste. <br />❑ SLUDGE <br />� REMARKS. ' <br />_'_ .. <br />NON -FRIABLE <br />❑ <br />ASBESTOS <br />FACILITY TICKET NUMBER <br />❑ WOOD <br />SIGNATURE OF AUTHORIZED AGENT DATE <br />❑ ASH <br />* `--fit -� = Il ; <br />❑ OTHER <br />TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />SCHEDULING .MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR <br />SUBJECT TO REFUSAL UPON ARRIVAL. ONGCING DAILY DELIVERIES MUST <br />BE SCHEDULED `NITH THE LANDFILL THE DAY SEF -ARE. <br />TO SCHEDULE CALL ;209) 982-4298 <br />MANIFEST 1 � V Q 6 <br />GENERATOR COPY <br />