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A'ft"WARD NO JOUWASTE MANIFEST <br />WASTESTE TREATMENT AND DISPOSAL FACILITY <br />INC. - JOB ACCEPTANCE NO. - /Z U <br />GENERATORREQUIRED <br />PERSONAL PROTECTIVE EQUIPMENT <br />L L rzId 7 L L.� vQ1_2 00/,,., ..4-74l <br />[]GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS <br />❑ TY-VEK []OTHER <br />• <br />v 3bX J5 <br />CITY, STATE.. ZIP _- .-. _ .. _ <br />SPECIAL HANDLING PROCEDURES: <br />- <br />PHONE <br />' <br />w7 37Y o y72 <br />CONTACT PERSON <br />1��� <br />SIGNATU E OF ArORIZED AGENT / TITLE DATE . <br />1.'.!/ ?4 - <br />WASTE PE _- <br />t- _- <br />RECEIVING FACILITY <br />❑ TREATMENT SOIL <br />❑ SLUDGE <br />❑ NON -FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />• <br />[j DISPOSAL SOIL <br />❑ WOOD <br />9999 SOUTH AUSTIN ROAD <br />❑I CONSTRUCTION SOIL <br />❑ ASH <br />'• <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY ., _ _. _ <br />� 1 <br />(209) 982-1009 FAX <br />._NOTES:._ TRUCK NUMBER <br />ADDRESS �' G <br />CITY, STATE, 23P-.-- <br />F �. -. END DUMP . BOTTOM DUMP ,.. , . TR <br />PHONE - .. .. _ _ , �..;. TRANSFER <br />_ . - _ <br />SIGNATURE OF AUTHORIZED AGE( 5OR DRIVER DATE ROLL-OFF(S)FLAT BED _ VAN DRUMS <br />El <br />FORWARD INC. LANDFILL cuBlcY ._ _�:`�_- <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 <br />reasonable efforts to promptly notify Disposer of its inability to accept the - DISPOSE BIO. AERATE ISMCME OTHER <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 />' <br />conditions are expected to change such that Forward will be able to accept <br />the waste. ❑ SLUDGE <br />REMARKS - <br />_ _ NON -FRIABLE <br />❑ <br />ASBESTOS <br />FACILITY TICKET NUMBER - <br />_... ❑ WOOD <br />- <br />SIGNATURE OF AUTHORIZED AGENT _ DATE -_ <br />❑ASH <br />l ! ? ! _ �'i�' ❑ OTHER <br />MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL* ANY UNSCHEDULED LOADS ARE <br />SCHEDULING <br />SUBJECT <br />TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL ?iE TAY BEFORE. <br />TO <br />SCHEDULE CALL (209) 982-4298 <br />3 5 11 6 8 <br />GENERATOR COPY MANIFEST* <br />