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NON-HAZ DOUS WASTE MANIFEST <br /> F&RWARD <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. �,, - Z y v <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ( C,,4 L,0 C W Ov0 QXD 77�- [-]GLOVES ❑GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> rJ - .13 <br /> ? SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> PHONE .., .� <br /> 7vl 37y. -(y '7-L <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHOWZED AGEPM/TITLE DATE _ <br /> clz <br /> WASTE TYPE7, _ _ RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ELDISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 7 .. (209) 982- 1009 FAX <br /> NAME ✓�� � N�/(M1� - = --NOTES-�_ _ - - TRUCK NUMBER <br /> ADDRESS - �7 <br /> • CITY,STATE,ZIP - <br /> PHONE. 7 END DUMPS.. BOTTOM DUMP - TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATOR F A THORIZE AGENT OR DRIVER. DATE ROC[=OFF(Sy. FLATBED' VAN. DRUMS <br /> El 11 <br /> CUBIC:YARDS._.:..,.:: . <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other - c/ <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL M _ (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 j' _ __ DISPOSE BIO AERATE,=j OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on SOIL / I <br /> weather or other site conditions.Forward shall notifythe Disposer when site }CJ J <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS 7 NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGOATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> r � <br /> � r ❑ 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) 982-4298t�5 b <br /> GENERATOR COPY MANIFEST # 3 5z <br />