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F ARD NON -HAZE _)OUS WASTE MANIFEST <br />,��/ WASTE TREATMENT AND DISPOSAL FACILITY <br />JOB ACCEPTANCE NO. -� — <br />M <br />GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />C vo C/O57 ❑GLOVES []GOGGLES []RESPIRATOR []HARD HAT <br />MAILING ADDRESS ❑ TY-VEK []OTHER <br />i�U KaX 7 � ��. <br />CITY, STATE, ZIP .r SPECIAL HANDLING PROCEDURES: <br />R/ L� LJ.5 <br />- PHONE <br />707 i y7Z <br />CONTACT PERSON <br />/e L /v/ <br />OF TITLE `/ <br />SIGNATURE AUTHgRIZED AGENT DATE <br />y <br />% <br />iWASTE <br />TYPE <br />RECEIVING FACILITY <br />7SLUDGE <br />TREATMENT SOIL ABLE ASBESTOS <br />FORWARD INC. LANDFILL❑ <br />[ DISPOSAL SOIL OOD <br />❑ CONSTRUCTION SOIL ❑ ASH <br />9999 SOUTH AUSTIN ROAD <br />❑OTHER <br />MANTECA, CALIFORNIA 95336 <br />(209) 982-4298 PHONE <br />GENERATING FACILITY _._. <br />re' <br />(209) 982-1009 FAX <br />NAME <br />NOTES: - _ TRUCK NUMBER <br />ADDRESS <br />'Al <br />-, <br />CITY, -STATE; ZIP C-,4 t+►O <br />PHONE- <br />-' 133 �/ ' 90 • :,--- <br />END DUMP BOTTOM DUMP - . TRANSFER <br />SIGNATURE OF THORIZED AGENT OR DRIVER DATE <br />ROLL-O❑FF($) 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 />J, <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 M-01 <br />OD_ (TO BE COMPLETED BY <br />FORWARD) <br />reasonable efforts to promptly notify Disposer of its inability to accept the <br />waste for any reason. If Forward's refusal to accept the waste is based on <br />_ _ _ - <br />�. <br />DISPOSE BIO AERATE STOCKPILE <br />OTHER <br />weather or other site conditions, Forward shall notify the Disposer when site <br />' <br />SOIL <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 />FACILITY TICKET NUMBER <br />ASBESTOS <br />❑ WOOD <br />SIdNAT'URE OF AUTHORIZED AGENT DATE <br />❑ ASH <br />❑ OTHER <br />SCHEDULING MUST 8E MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL ! ANY UNSCHEDULED LOADS ARE <br />`JBJECT TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDUL_0 <br />WITH THE LANDFILL THE DAYBEFORE. <br />SCHEDULE CALL (209) 982-4298 <br />_ <br />GENERATOR CCPY MANIFEST # 3 5 0 9 j <br />