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NON-HAz. JOUS WASTE MANIFEST <br />I !• . WASTE TREATMENT AND DISPOSAL FACILITY <br />WARD <br />INC. .JOB ACCEPTANCE NO. <br />GENERATORr <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />C (_14 v ID L W 000 L�lG <br />[]GLOVES ❑ GOGGLES []RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS <br />❑ TY-VEK []OTHER <br />Ci L�r✓� �5 S — ' -. <br />SPECIAL HANDLING PROCEDURES: <br />C[TY, STATE, 23 --. :....:.:_ <br />- PHONE _.. <br />CONTACT PERSON. <br />SIGNATUR F AUTHORIZED AGENT / TILE DATE .:. - ;, "' <br />L <br />WASTE.TYPE . _: y _ <br />RECEMNG FACILITY <br />❑ SLUDGE <br />' <br />FORWARD INC. LANDFILL <br />❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br />• 0 DISPOSAL SOIL ❑ WOOD <br />9999 SOUTH AUSTIN ROAD <br />❑ CONSTRUCTION SOIL ❑ ASH <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY .,, ; -_ _ _:_ _.... <br />(209) 982-1009 FAX <br />.. <br />NAME <br />TRUCK NUMBER <br />ADDRESS <br />• <br />5�/ter ! ��� �, M <br />•CITY, STATI~ ZIP -: ,� x __ . � .. <br />5 <br />PHONE <br />END DUMP BOTTOM DUMP TRANSF ER <br />- <br />❑ ❑. - ❑ <br />SIGNATURE OF AUTHORIZED AGENTOR DRIVER DATE. - <br />ROLL-OFF(S) FLAT-BED, VAN DRUMS <br />17e-7,a44 r <br />FORWARD INC. LANDFILL <br />,Brc./YfARDs <br />Forward shall have no obligation to accept the waste if weather or other <br />7 <br />DISPOSAL M <br />OD: - (TO BE COMPLETED <br />BY FORV"D) <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 />reasonable efforts to promptly notify Disposer of its inability to accept the <br />_ ,, _ <br />DI 1310 <br />.. _ <br />SMOWLE -OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />the Disposer when site <br />SOIL / <br />I-AERATE <br />weather or other site conditions, Forward shall notify <br />• conditions are expected to charge such that Forward will be able to accept <br />the <br />❑ SLUDGE <br />waste. <br />• REMARKS. — - -NON-FRIABLE <br />' <br />❑ <br />ASBESTOS <br />FACILITY TICKET NUMBER - -_ <br />❑ WOOD <br />- SfGNAVRE OF AUTHORIZED AGENT DATE :' _ -,:, <br />❑ASH <br />OTHER <br />SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR <br />SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST <br />TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE <br />BE SCHEDULED WITH 7HE LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL (209) 082-1298 <br />MANIFEST* 350071 <br />GENERATOR COPY <br />