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NON-HAZE .. ,JOUS WASTE MANIFEST <br />FOR WASTE TREATMENT AND DISPOSAL FACILITY <br />WARD <br />INC- JOB ACCEPTANCE NO. <br />GENERATOR <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />,- <br />[]GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS <br />❑ TY-VEK ❑ OTHER <br />?o ox %• <br />SPECIAL HANDLING PROCEDURES: <br />CITY, STATE, ZIP <br />- <br />PHONE <br />7Y 6'y' ! z - - <br />CONTACT PERSON <br />1�i/GC tYlC ��✓ � <br />SIGNATURE OF AUTHOPIZED AGENZ / TITLE DATE <br />.• <br />* 111a 'raj^� I� <br />WASTE TYPE/ <br />RECEIVING FACILITY <br />❑ TREATMENT SOIL <br />❑ SLUDGE <br />❑ NON-FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />• <br />DISPOSAL SOIL <br />❑ WOOD <br />9999 SOUTH AUSTIN ROAD <br />[]-CONSTRUCTION SOIL <br />❑ ASH <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY <br />(209) 982-1009 FAX <br />NAME <br />NOTES: :.. _ - TRUCK NUMBER <br />V <br />ADDRESS _ .. <br />• <br />CITY, STATE. ZIP'_ _ <br />END DUMP BOTTOM DUMP -TRANSFER <br />PHONE <br />q- 7 6G' l <br />11 11SIGNATURE <br />OF AUTHORITEP_AGENT OR DRIVER DATE <br />ROLL-OFF(S) FLAT-BED VAN DRUMS <br />7-9 <br />FORWARD INC. LANDFILL <br />CUBIC YARDS <br />if <br />/ <br />Forward shall have no obligation to accept the waste weather or other <br />DISPOSAL ME7 <br />OD: (TO BE COMPLETED <br />BY 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 />DISPOSE BIO AERATE <br />STOCKPILE OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />Disposer <br />SOIL <br />/ <br />weather or other site conditions, Forward shall notify the when site <br />conditions are expected to change such that Forward will be able to accept <br />the waste. <br />❑ SLUDGE <br />REMARKS <br />NON-FRIABLE <br />❑ <br />ASBESTOS <br />FACILITY TICKET NUMBER <br />❑ WOOD <br />- <br />SIGNATURE OF AUTHORIZED AGENT DATE <br />❑ ASH <br />!-� (� `� <br />❑ OTHER <br />SCHEDULING <br />SUBJECT <br />MUST BE MADE PRIOR TO 4:00 ?.M. THE DAY PRIOR <br />TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST <br />TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />BE SCHEDULED WITH THE LANDFILL -HE DAY BEFORE. <br />TO <br />SCHEDULE CALL ;209) 982-4298 <br />MANIFEST # " G 1 9 8 <br />GENERATOR COPY <br />