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NON-HAD-jOUS WASTE MANIFEST FOWARDWASTE TREATMENT AND DISPOSAL FACILITY IINr- JOB ACCEPTANCE NO. GENERATOR L MAILING ADDRESS FD 3q 7Y5' _ CITY, STATE, ZIP PHONE 707 37`l 6,:? -r - - CONTACT PERSON SIGNA RE OFAUTH0912,1ED AGENT/ITLE DATE WASTE TYPE ,-j ❑ TREATMENT SOIL Q DISPOSAL SOIL ❑ CONSTRUCTION SOIL ❑ SLUDGE ❑ NON -FRIABLE ASBESTOS ❑ WOOD ❑ ASH ❑ OTHER GENERATING FACILITY NAME L: ` Z ADDRESS _ ... CIN, PHONE _. OF AUTHORIZED AGENT OR DRIVER DATE. FORWARD INC. LANDFILL 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 reasonable efforts to promptly notify Disposer of its inability to accept the 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 conditions are expected to change such that Forward will be able to accept the waste. REMARKS FACILITY TICKET NUMBER - SIGNATURE OF AUTHORIZED AGENT DATE REQUIRED PERSONAL PRUT EG I IVt tUUWMtN I []GLOVES ❑ GOGGLES ❑ RESPIRATOR [:]HARD HAT ❑ TY-VEK []OTHER SPECIAL HANDLING PROCEDURES: RECEIVING FACILITY FORWARD INC. LANDFILL 9999 SOUTH AUSTIN ROAD MANTECA, CALIFORNIA 95336 (209) 982-4298 PHONE (209) 982-1009 FAX NOTES: _MI TRUCK NUMBER' END DUMP- BOTTOM DUMP. , TRANSFER_ El ROLL-OFF(S) FLAT BED "-VAN - DRUMS ❑ ❑ ❑ ❑ CUBIC YARDS DISPOSAL METHO . (TO BE COMPLETED BY FORWARD) DISPOSE Bio AERATE IsTol OTHER UtOIL ❑ SLUDGE NON -FRIABLE ❑ ASBESTOS ❑ WOOD ❑ ASH ❑ OTHER SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO E:CPtCTED AHHIVAL •HNT uNal,�ttuULtU LUNUJ ,ani SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. TO SCHEDULE CALL (209) 982-4298 MANIFEST # ? � 0 8 GENERATOR COPY