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QARDRW NON-HAZ. JOUS WASTE MANIFEST WASTE TREATMENT AND DISPOSAL FACILITY INC. JOB ACCEPTANCE N0. C,ti,,J :1-E _Vv_7 GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT []GLOVES ❑ GOGGLES []RESPIRATOR ❑HARD HAT MAILING ADDRESS []TY-VEK ❑OTHER 7s CITY, STATE, Z!P .- ,...._ SPECIAL HANDLING PROCEDURES: _ .._ _ • ,Q1 Z.) PHONE CONTAC�PERSON SIGNATURE OF AUTHORIZED AGEN�j / TITLE DATE WASTE TYPE J _ . RECEIVING FACILITY - ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL • Er DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ASH ❑ OTHER MANTECA, CALIFORNIA 95336 (209) 982-4298 PHONE GENERATING FACILITY -.. y ;, (209) 982-1009 FAX NAMEjij `� o`��"� 1 NOTES -. TRUCK NUMBER ADDRESS �.: - 77_ CITY, STATE, ZIP __ 4 PHONE END DUMP �; _. BOTTOM DUMPS �; TRANSFER__, SIGNATURE OF UTHED AGENT OR DRIVER DATE _ - ROLL-0FF(S}.. _u FLAT BED VAN DRUMS FORWARD INC. LANDFILL cuBlcyARDs :__ 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 DISPOSAL M OD: -(TO BE COMPLETED BY FORWARD) reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO__ AERATEOTHER s1cril waste for any reason. If Forward's refusal to accept the waste is based on weather or other site conditions, Forward shall notify the Disposer when site OIL / conditions are expected to change such that Forward will be able to accept the waste. ❑ SLUDGE REMARKS NON -FRIABLE ❑ `_ FACILITY TICKET NUMBER ASBESTOS _ . _ _ �. ❑WOOD - SIGNATURE OF AUTHORIZED AGENT DATE f ❑ ASH CI �� ! I� — / ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAIl2f DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. TO SCHEDULE CALL (209) 982-4298 MANIFEST* 3 5 0 � 9 GENERATOR COPY