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r <br />FORWARD <br />INC. JOB ACCEPTANCE NO. <br />NON-HAZ, ...DOUS WASTE MANIFEST <br />WASTE TREATMENT AND DISPOSAL FACILITY <br />GENEPTOR ^ <br />tJ A: %�',-- <br />REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />❑ GLOVES ❑ GOGGLES ❑ RESPIRATOR []HARD HAT <br />MAILING AD ESS <br />❑ TY-VEK ❑ OTHER <br />�✓.lieu-- '� L:S <br />• CITY,ST� ZIP _ <br />SPECIAL HANDLING PROCEDURES: <br />• 7i L) V !"S74 - <br />.. <br />PHONE <br />• <br />3 - L17 <br />f?11�%- <br />CONTACT PERSON <br />SIGNATURE OF AUTHORIZED �G, ENT TITLE: DATE . <br />�t 1 /o-'/- 7 , <br />WASTE TYPE_ /i <br />RECEIVING FACILITY <br />❑ SLUDGE <br />• ❑ TREATMENT SOIL <br />❑ NON -FRIABLE ASBESTOS <br />FORWARD INC. LANDFILL <br />• a DISPOSAL SOIL <br />❑ <br />9999 SOUTH AUSTIN ROAD <br />❑ CONSTRUCTION SOIL <br />ASH <br />ASH <br />•• <br />❑ OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY _ <br />(209) 982-1009 FAX <br />NAME :. - _ <br />ADDRESp Q <br />_- NOTES .. .:... : ;. _;..: TRUCK NUMBER <br />• CITY, STATE; ZIP' y <br />• _ - ..__ <br />PHONE <br />END DUMB ; . _. BOTTOM DUMP. TRANSFER <br />SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ' .: <br />; ROLL-OFF(S) . - FLAT-BED VAN.DRUMS <br />FORWARD INC. LANDFILL <br />CUBIC YARDS.: <br />Forward shall have no obligation to accept the waste if weather or other <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 />DISPOSAL METHOD: (TO BE COMPLETED <br />BY <br />FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />DISPOSE BIO AERATE <br />STOCKPILE <br />. OTHER <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />Forward <br />[:I -SOIL <br />weather or other site conditions, shall notify the Disposer when site <br />i' <br />' conditions are expected to change such that Forward will be able to accept <br />the waste. <br />❑ SLUDGE <br />REMARKS- <br />NON -FRIABLE <br />❑ <br />• <br />_,_- <br />FACILITY TICKET NUMBER <br />ASBESTOS <br />❑ WOOD <br />- SI�NATURE OF AUTHORIZED AGENT DATE <br />- •: <br />❑ ASH <br />❑OTHER <br />SCHEDULING Wbi tit jAAUt NHIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS AHE <br />SUBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAIL`( DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br />TO SCHEDULE CALL (209) 982-•1298 <br />GENERATOR COPY MANIFEST # � Q q <br />