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ARD NON-HAZ, 30US WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE NO. /2 �v <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> C []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADD-R�E�,SS ❑TY-VEK []OTHER <br /> !7 v � '`�" . 1 S -••-.-� -_•- - SPECIAL HANDLING PROCEDURES: <br /> CITY,SIKE�ZIP <br /> PHONE <br /> '07 3"Ll &q7Z - <br /> CONTACT PERSON <br /> ll ILL Mr <br /> SIGNATURE OF AUTO G.RIZED /TITLE DATE <br /> * T <br /> WASTE TYF j RECEIVING:FACILITY . :;... <br /> P <br /> ❑ SLUDGE <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME .f - -_� NOTES r - .. .,...TRUCK NUMBER _ <br /> ADDRESS _ <br /> • CITY,STATE.ZIP . <br /> __- <br /> PHONE` _:. _END DUMP_ BOTTOM DUMP r TRANSFER _ <br /> _ ❑ <br /> SIGNATURE.OFAUTHORIZED AGENfbk&NER DATE ROLL-0FF(SI FLAT BED VAN DRUMS <br /> �r 1 o-a7-9y . ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other 1 <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FO D): <br /> impairs the safe and effective operation of the Landfill. Forward shall use -_ - <br /> zr ` - <br /> reasonable efforts to promptly notify Disposer of its inability to accept the ,;�sx;.;+:1+ >;DlS 810. AERATE STOCKPLE OTHER. . <br /> waste for any reason. If Forward's refusal to accept the waste is based on 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-FRWBLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> _.. ❑ WOOD <br /> SIGF ATURE OF AUTHORIZED AGENT =; DATE"' _. <br /> ❑ ASH <br /> �C a : 1 i - (' ❑ 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 SC4EDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHIiDULE CALL (209) 982-4298 GENERATOR COPY MANIFEST # 35041 <br />