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NON-HAZA, .JOUS WASTE MANIFEST <br /> FWWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. c wi,�, — -Z <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> c L 40?c C W COO C/,, /4S77) []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK []OTHER <br /> w 3 CA / 5y - SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP - <br /> PHONE <br /> 7c.7 .3 7`� 7Z- <br /> CONTACT PERSON' <br /> SIGNATU E OF AUTHOOD A?EN /TITLE DATE - <br /> �y / •�/. tis y i � G, <br /> U <br /> WASTE TYP RECEIVING FACILITY <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 /> v <br /> NAME. NOTES TRUCK NUMBER <br /> ADDRESS (l 2- <br /> /11ZFI �4 <br /> • CITY,STATE.ZIP <br /> • PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATUREF AUTHORIZED AGENT OR DRNER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 Landfitl. Forward shall use DISPOSE BIO AERATE 1=1OTHER <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 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 /> _ ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE _ <br /> / ❑ ASH <br /> (L <br /> 7� i, - 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 SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL ',2091 982-4298 MANIFEST # 3 5 0 4 6 <br /> GENERATOR COPY <br />