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NON-HA2__ ,DOUS WASTE MANIFEST <br /> WARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> IIA/r. JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> L r C O C(Q ';7Tp []GLOVES ❑GOGGLES ❑RESPIRATOR [:]HARD HAT <br /> MAILING ADDRESS y ❑TY-VEK []OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> • ,ill VlSTAr <br /> PHONE _ <br /> ) 07 <br /> CONTACT PERSON <br /> 1=,/LC L vd`�+f4L f>,. - <br /> SIGNATUR F AUTHQRIZED AGENT/TITLE DATE.' <br /> WASTE TYP _. . RECEIVING FACILITY <br /> i <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 /> t NAME. , r ., — _� ►; �NOTES.r ._ ..,..._ t:� rr TRUCK NUMBER <br /> ADDRESS <br /> _ "✓5s � �res 1,w ,_�'1►��-��3 .� . K : . , . <br /> _ <br /> • • CITY,STATE,ZIP <br /> PHONE ; :. ..END DUMP BOTTOM DUMP_ ._._ _TRANSFER <br /> SIGNATURE OF AUTHORIZg"ENT OR DRIVEl3 DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> /G <br /> FORWARD INC. LANDFILL cuelc YaR/aS <br /> Forward shall have no obligation to accept the waste if weather or other / ( I <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL M OD-_ (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 BIO AERATESTOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on j <br /> weather or other site conditions,Forward shall notify the Disposer when site ET SOIL <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 /> FACIUTY,,TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATtIIRE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST 3E 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 --.ALL ;209! 982--1298 MANIFEST * 35060 <br /> GENERATOR COPY <br />