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FORWARD NON-HAz 'DOUS WASTE MANIFEST WASTE TREATMENT AND DISPOSAL FACILITY INC JOB ACCEPTANCE NO Iy, — 12 y GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT ❑GLOVES E]OGOG RLES []RESPIRATOR []HARD HAT ❑ MAILING ADDRESS TY-VEK ! rJ 3 6X SPECIAL HANDLING PROCEDURES: CITY, STATE, ZIP PHONE CONTA& PERSON SIGNATURE OF AUTHrZED AGENT / TITLE DATE • WASTE TYPF RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL • Q DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING;FACIUTY _ (209) 982-4298 PHONE (209) 982-1009 FAX NAME - NOTES: TRUCK NUMBER 3 ADDRESS- • • CITY, STATE, ZIP PHONEa�� 3� Y ! _ _ .- :_ ' .. �_. , .. �_ END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS FORWARD INC. LANDFILL CUBIC%YARDs Forward shall have no obligation to accept the waste if weather or other / S, C conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) impairs the safe and effective operation of the Landfill. Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept the �. DISPOSE BIO AERATE ISMOqU. OTHER waste for any reason. If Forward's refusal to accept the waste is based on SOIL 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. ❑ SLUDGE REMARKS NON -FRIABLE ❑ ASBESTOS FACILITY TICKET NUMBER E] WOOD • SIGNATURE OF AUTHORIZED AGENT DATE ❑ ASH ❑OTHER SCHEDULING MUST BE MADE PRICR TO 4:00 P.M. -HE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL. 3NGOING DAILY DELIVERIES MUST 3E SCHEDULED WITH THE LANCF1LL THE DAY BEFORE. TO SCHEDULE CALL (209) 982-4298 MANIFEST # -1,5 0 .J 4 GENERATOR COPY