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NON-HAZ. DOUS WASTE MANIFEST <br />FOWWASTE TREATMENT AND DISPOSAL FACILITY <br />ARD <br />INC JOB ACCEPTANCE NO. - o <br />GENERATOR <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />(2 L4 L- OF I CC 01,Q -i5 7-) <br />[]GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br />MAILING ADDRESS <br />❑ TY-VEK []OTHER <br />CITY, STATF_ ZIP <br />SPECIAL HANDLING PROCEDURES: <br />' <br />91 <br />PHONE <br />Y Y 71 <br />CONT CT�PERS0t1� 37(/ <br />! 1% f C I'7 e J.3 0 rv� 4 I' <br />SIGNATURE OFA?qRIZED A ENT / TITLE DATE . <br />? :� �• <br />WASTE.TYPE _ , <br />_ _..- <br />RECE1VING FACILITY <br />❑ SLUDGE <br />FORWARD INC. LANDFILL <br />❑ TREATMENT SOIL <br />❑ NON -FRIABLE ASBESTOS <br />• <br />�} DISPOSAL SOIL <br />❑ WOOD <br />9999 SOUTH AUSTIN ROAD <br />CONSTRUCTION SOIL <br />❑ ASH <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY <br />J 7r <br />(209) 982-1009 FAX <br />NAME .,;_/'{- .-�� ��%% -: <br />. v ., . >� �_. __. - ,:-:-TRUCK NUMBER <br />ADDRESS- <br />• <br />_.. _ <br />C[TY STATE•Z P;; <br />... END DUMP::_ BOTTOM DUMP ....TRANSFER .- <br />PHONE `:: -. ii... -�... r_ .. _.._ . <br />:•El <br />.. ._ - _ ..._ <br />SIGNATUREOFAUTHORI GENT. OR DRIVER "r DATE <br />ROLL-OFF(S) FLAT-BED _ _.. VAN DRUMS <br />" <br />❑ ❑ ❑ ❑ <br />ty(DA _ <br />FORWARD INC. LANDFILL <br />cuslc.YAR as_,(7"_ <br />if <br />Forward shall have no obligation to accept the waste weather or other <br />DISPOSAL METHOD: <br />(TO BE COMPLETED <br />BY <br />FORWARD) <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 />-.. .. . - w. , <br />S Bio AERATE <br />.._.. _. <br />OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />Forward Disposer site <br />❑'SOIL <br />weather or other site conditions, shall notifythe when <br />• <br />conditions are expected to change such that Forward will be able to accept <br />the waste. <br />❑ SLUDGE <br />• <br />REMARKS - �,- <br />_- — <br />NON -FRIABLE <br />❑ <br />- <br />ASBESTOS <br />FACILITY TICKET NUMBER <br />- - <br />❑ WOOD <br />- <br />SIGNATURE OF AUTHORIZED AGENT DATE <br />❑ ASH <br />❑ OTHER <br />SCHEDULING <br />MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR <br />TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />SUBJECT <br />TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST <br />BE SCHEDULED WITH THE LANDFILL 7HE DAY BEFORE. <br />\O <br />SCHEDULE CALL (209) 982-4298 <br />MANIFEST # 3 11, 7 <br />GENERATOR COPY <br />v <br />