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FORWARD NON-HAZ SOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE NO. C - /Z V0 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> C(4uPC' L W0cD C& 4Sr,9 []GLOVES []GOGGLES []RESPIRATOR [-]HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 00 <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> • �:I t� _�1 f� t/l C <br /> PHONE <br /> 7C 7 37y :6 /7z _ <br /> CONTACT PERSON <br /> ij/LL !'lIC fDGN<)c. /--> <br /> SIGNATURE OF AUTHQl IZED AGENT/rI TLE DATE <br /> WASTE PF - RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • [ DISPOSAL SOIL ❑ WOOD <br /> CONSTRUCTION SOIL ❑ ASH <br /> 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY. ,,.; _ .. _; .: (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> Com/ <br /> NAME INOTE_S , :TRUCK NUMBER_,_ �,�.� .�__. .. <br /> ADDRESS S���J`-r�.t,���-�j�"i� !.�✓��„l►�,/.�-�. <br /> • CITY, - <br /> • µ .. . END DUMP BOTTOM DUMP TRANSFER <br /> PHONE .' $.�'�_ O <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN. DRUMS <br /> I <br /> FORWARD INC. LANDFILL cuBlc YARDS- <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 DISPOSAL METHOD: (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 DISPOSE 810. AERATE(STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on Q SOIL <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 /> the waste. ❑ SLUDGE <br /> • REMARKS - <br /> NON-FRIABLE <br /> -: _ c ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGtIATURE OF AUTHORIZED AGENT DATE <br /> E] ASH <br /> * . f`? ❑ <br /> 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 MANIFEST # 3 5 018 <br /> GENERATOR COPY <br />