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NON-HAZt ._ .30US WASTE MANIFEST <br /> FWWARDWASTE TREATMENT AND DISPOSAL FACILITY <br /> /NC. JOB ACCEPTANCE N0. - /Z Y v <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ti IiC L (,�jUU(� flu / <br /> []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS _: :.: :_.. ..:_:L ❑TY-VEK ❑OTHER <br /> rJ 13o 7y SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> PHONE _ <br /> CONTACT PERSON. <br /> MILL me Cc/V4 L!� - <br /> SIGNATURE OF AUTH?RV- D AGENT/T= 1012 7 14 v <br /> J � <br /> • WASTP,fY�'E RECEMNG:FACILITY <br /> ❑ SLUDGE <br /> ' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • S-DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> �U (209) 982-1009 FAX <br /> NAME. . '-;�._. . <br /> -TRUCK NUMBER <br /> V&Z 1RU C-K_/N (I. <br /> ADDRESS - <br /> • CITY,.STATE Z1P ,. w. '- - fl TLIZ R A D <br /> PHONE r END DUMP ;� .BOTTOM DUMP _- TRANSFER <br /> .r..:.:-':._er� ;�. _-- .;n��.�A`.:ear.. ...-, <..:�... -+c....—.tea_.. .>_ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED µ. VAN DR?MS <br /> * 10-97-9q ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC'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 DISPOSE ,�T �� <br /> reasonable efforts to promptly notify Disposer of its inability to accept the r _._ . f <br /> STOCKPILE OTHL <br /> waste for any reason. If Forward's refusal to accept the waste is based on CYSOIL <br /> weather or other site conditions,Forward shall notify the Disposer when site I..f <br /> • conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> REMARKS NON-FRIABLE <br /> 17-1 ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <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 12091982-4298 MANIFEST # 35042 <br /> GENERATOR COPY <br />