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NON-HAZk SOUS WASTE MANIFEST <br /> FWWARDWASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> C(L }V)t C 4s7/) ❑GLOVES []GOGGLES []RESPIRATOR []HARD HAT <br /> MAILING ADDRESS7 _ ❑TY-VEK C]OTHER <br /> &.1 __ /-S - SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP <br /> iv a ✓�STy - -_. �� . <br /> PHONE - <br /> 3 7Z <br /> CONTACT PERSON <br /> i�SIGNATUR OF AUTHORED AG /TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY `t <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ® 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 - •N. UMBER <br /> OTES� . TRUCK N <br /> ADDRESS <br /> • CITY,STATE.ZIP <br /> • - END DUMP BOTTOM DUMP TRANS R <br /> PHONE_ <br /> ❑ ❑ . <br /> • . SIGNATLPE OF AUTHORIZED AGENT OR DRIVER DATE ,.: ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC LANDFILL cUe'c 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 B10. AERATE ISTOCtcPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _ _r <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 /> REMARK$ -. NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> - J ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT _ _ DATE <br /> ❑ ASH <br /> _�I \ ' I — f ( ❑ 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 BE=ORE. <br /> TO SCHEDULE CALL 1209.1982-4298 MANIFEST * 35062 <br /> GENERATOR COPY <br />