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NON-HAZ " 000S WASTE MANIFEST <br />I N <br />F SI RD WASTE TRE -mi MENT AND DISPOSAL FACILITY <br />INC. JOB ACCEPTANCE N0. <br />GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />O(., cot✓;uR C!G f� 51,E ❑ GLOVES ❑ GOGGLES ❑ RESPIRATOR ❑ HARD HAT <br />MAILING_ ADDRESS 1' [TY-VEK :OTHER <br />% S� SPECIAL HANDLING PROCEDURES: <br />CITY, STATE. ZI <br />l -'/v UISTi� Cif - <br />PHONE _ _ _•_ ' <br />4� t <br />CONTACT PERSON y <br />SIGNATUFjff67 AU,THq' RqM AGENT / TITLE DATE , <br />WASTE TaCCPERECEMNG FACILITY .� <br />❑ SLUDGE <br />❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS <br />II DISPOSAL SOIL ❑ WOOD <br />❑ CONSTRUCTION SOIL ❑ ASH <br />❑ OTHER <br />GENERATING' FACILITY <br />FORWARD -INC. LANDFILL <br />9999 SOUTH AUSTIN ROAD <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />(209) 982-1009 FAX <br />NAME ' / f .. 0 —.. _ NOTES _.. r __ _ ._ . TRLICK NUMBER <br />CITY3TA ; 7JP <br />fl <br />G� <br />PHONE :.: <br />M ,> <br />---END DUMP <br />-BOTTOM DUMP TRANSFER <br />__.� <br />SIGNATURE OF AUTHORIZED AGENT OR DRIVER J <br />DATE <br />`ROLL-0FF(SjFLAT-BED <br />_`VAN DRUMS <br />- �❑ <br />- <br />- <br />❑ <br />❑ ❑ <br />FORWARD INC. LANDFILL <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 <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 />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 <br />conditions are expected to change such that Forward will be able to accept <br />CUBIC YARDS.. <br />JK I/' Y <br />DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <br />.-.. _DISPSE <br />/OBIO AERATE STOC OTHER_ <br />Er SOIL I / I I <br />the waste. _ ❑ SLUDGE <br />IEMARKS _ <br />FACILITY TICKET NUMBER <br />SIGNATURE OF AUTHORIZED AGENT <br />DATE <br />NON-FRIAc <br />❑ ASBESTOS <br />❑ WOOD <br />❑ ASH <br />❑ OTHER <br />SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br />SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORF <br />TO SCHEDULE CALL (209) 982-4298� <br />GENEflATOR COPY MANIFEST # 3 � iJ Q <br />