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r NON-HAZi--L)OUS WASTE MANIFEST <br /> F&RWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> qb ❑GLOVES []GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> I70 7 <br /> CITY,STATE,-Z1P SPECIAL HANDLING PROCEDURES: <br /> �. - <br /> PHONE - <br /> -7c 7 -7-,71 1 <br /> CONTACT PERSON' <br /> tE/LC. t'-/Q 06/vAt D <br /> SIGNATURE OF AUTh QRIZED AGENT <br /> WAS Y� RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY _�• ... '_: (209) 982-4298 PHONE <br /> CC (209) 982- 1009 FAX <br /> �J�r��v <br /> NAME ,.:. k.- !i NOTES ..,_,, TRUCK.NUMBER <br /> L / <br /> ADDRESS f <br /> . • CITY..STATE;7�P ., � OlCY �r. �� _ - _ <br /> • PHONE -TRANSF <br /> EN UMP BOTTOMDUMP FSR <br /> SIGNATUREOF AUTHORIZED-AGENT OR DRIVER DATE 77'" ; ROLL-OFF(S} -At-BED VAN DRUMS <br /> 17 Z7- <br /> FORWARD INC. LANDFILL cuBic.YARDs< 1 - <br /> Forward shall have no obligation to accept the waste if weather or other S C <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSALMETHOD:,.r: (TO BE COMPLETED BY FORWARD} <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 .Fs +�.. _ �_ RATE STOC OTHER <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 /> the waste. ❑ SLUDGE <br /> • REMARKS , NON-FRIABLE <br /> „_ _ _ _ �- ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNAtUREOF AUTHORIZED AGENT DATE. _. <br /> f ❑ ASH <br /> { — 1 �' ❑ 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 (2091982-4298 MANIFEST * 3501-7 <br /> GENERATOR COPY <br />