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FWASTE <br />GRWARD <br />NON-HAZ. SOUS WASTE MANIFEST <br />TREATMENT AND DISPOSAL FACILITY <br />INC. JOB ACCEPTANCE NO. ; �- ��, — /-Z �, <br />GENERATOR <br />C �p �T,ZL <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />[:]GLOVES ❑GOGGLES CHARD HAT <br />(-,a C)o <br />❑RESPIRATOR <br />MAILING ADDRESS <br />❑ TY-VEK ❑ OTHER <br />/ <br />; .:.._ _ _ <br />CITY, STATEZ1P: <br />SPECIAL HANDLING PROCEDURES: <br />- PHONE . <br />CONTA&T PERSON <br />SIGNATUREPF AUTI-19RIZED AGEWT ! TITLE DATE: <br />WASTe7YVE <br />_..... <br />RECEIVING FACILITY <br />❑ SLUDGE <br />❑ TREATMENT SOIL <br />❑ NON -FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />• ( DISPOSAL SOIL <br />❑ CONSTRUCTION SOIL <br />❑ <br />❑ ASH ASH <br />9999 SOUTH AUSTIN ROAD <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />982-4298 PHONE <br />GENERATING FACILITY:,: - s.- 1-1(209) <br />-7 <br />(209) 982-1009 FAX <br />NAME <br />._-- -- - _ _... _. _... _.._° - .__ •__,..........W �..:.: <br />NOTES- TRUCK NUMBERy - <br />_ <br />ADDRESS <br />_ _.. <br />CITY„STATE, ZIPy. <br />y <br />PHONE �.,..'.. _ :_ - -_ _ �_. <br />END DUMP.. _ BOTTOM DUMP TRANSFER <br />SIGNATURE OFAUTHORIZED AGENT OR DRIVER DATE 'T <br />K <br />-OFF(S) FLATBED VAN DRUMS <br />* , ro_Z 7�Y <br />❑ ❑ ❑ ❑ <br />FORWARD INC. LANDFILL <br />CUBIc:YARos.:::;;;. <br />Forward shall have no obligation to accept the waste if weather or other <br />v <br />/ C <br />conditions impair the safe and effective disposal of the waste or if the waste <br />impairs the safe and effective operation of the Landfill. Forward shall use <br />DISPOSAL METHOD: <br />: (TO BE COMPLETED <br />BY <br />FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />_ - <br />DISPOS _ BIG,,; AERATE <br />STOCKPILE_OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />weather or other site conditions. Forward shall notify the Disposer when site <br />SOIL <br />�- <br />conditions are expected to change such that Forward will be able to accept <br />the waste. <br />❑ SLUDGE <br />REMARKS <br />❑NON -FRIABLE <br />• <br />FACILITY TICKET NUMBER <br />ASBESTOS <br />_ <br />❑ WOOD <br />- SIGNATURE OF AUTHORIZED AGENT DATE <br />❑ ASH <br />_- _ �i <br />❑ OTHER <br />SCHEDULING MUST SE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO <br />EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAIL7 DELIVERIES NIUST <br />2E SCHEDULE -D WITH THE LANCFiLL THE DAY BEFORE. <br />TO SCHEDULE CALL (209) 982-4298 <br />MANIFEST # v � 069 <br />GENERATOR COPY <br />