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WARD NON-HAS. �DOUS WASTE MANIFEST jF �% WASTE TREATMENT AND DISPOSAL FACILITY /NC. JOB ACCEPTANCE N0. ,, - GENERATOR 1 � r7L C Lvc70f7 2�o A971 MAIUW.-A,ADDRESS 0. CITY, STATE. ZIP PHONE i07 37y v7� CONTACT PERSON: /- L V7(:_ i ALIS SIGNATUR§ OF AUTHORIZEDGG�NT / TITLE WASTE TYP DATE ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS Q, DISPOSAL SOIL ❑ WOOD ❑ CONSTRUCTION SOIL ❑ ASH ❑ OTHER GENERATING FACILITY, REQUIRED PERSONAL PROTECTIVE EQUIPMENT []GLOVES ❑GOGGLES ❑ RESPIRATOR []HARD HAT I ❑ TY-VEK ❑ OTHER SPECIAL HANDLING PROCEDURES: - I RECEIVING FACILITY f , FORWARD INC. LANDFILL 9999 SOUTH AUSTIN ROAD MANTECA, CALIFORNIA 95336 (209) 982-4298 PHONE (209) 982-1009 FAX NAME _. - \/ \ NOTES_ _ :. q!5PUMBER . ADDRESS _, CIY, S..E; ZJR-• __= , . C.ckcc.�le C- FORWARD INC. LANDFILL Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste impairs the safe and effective operation of the Landfill. Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the waste for any reason. If Forward's refusal to accept the waste is based on weather or other site condifions. Forward shall notify the Disposer when site conditions are expected to change such that Forward will be able to accept the waste. REMARKS FACILITY TICKET NUMBER - - CUBIC YARDS ^/,< DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) _ 4 DISPOSE BIO': I.AERATE I OTHER SOIL ❑ SLUDGE ❑ NON -FRIABLE ASBESTOS _ ❑ WOOD SIGAATURE OF AUTHORIZED AGENT DATE. '� ~ ❑ ASH *;\ - ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ,ARE SUEJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BE. ORE. TO SCHEDULE CALL (209) 982-4298 GENERATOR COPY 3 5 0 6 0 MANIFEST # OM DUMP TRANSFERPHONE SIGNATURE -OF, tLZ IORZED.,A R DRIVER DATE., 7., jq- ROLL-OFF(S) - w FLAT-BED VAN DRUMS ❑ ❑ ❑ ❑ FORWARD INC. LANDFILL Forward shall have no obligation to accept the waste if weather or other conditions impair the safe and effective disposal of the waste or if the waste impairs the safe and effective operation of the Landfill. Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the waste for any reason. If Forward's refusal to accept the waste is based on weather or other site condifions. Forward shall notify the Disposer when site conditions are expected to change such that Forward will be able to accept the waste. REMARKS FACILITY TICKET NUMBER - - CUBIC YARDS ^/,< DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) _ 4 DISPOSE BIO': I.AERATE I OTHER SOIL ❑ SLUDGE ❑ NON -FRIABLE ASBESTOS _ ❑ WOOD SIGAATURE OF AUTHORIZED AGENT DATE. '� ~ ❑ ASH *;\ - ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ,ARE SUEJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BE. ORE. TO SCHEDULE CALL (209) 982-4298 GENERATOR COPY 3 5 0 6 0 MANIFEST #