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FORWARD - NON-HAZARDOUS WASTE MANIFEST <br /> �►� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> "'4 _ - _ _ Q GLOVES ❑GOGGLES ❑RESPIRATOR 0 HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> CITY STATE, ZIP - V f SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> _ f <br /> WASTE TYPE RECENING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> QDISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> = - (2091 932- 1009 FAX <br /> NAME - a NOTES , ,`k TRUCK NUMBER <br /> ADDRESS <br /> CITY, STATE, ZIP r �� <br /> PHONE l j J END DUMP BOTTOM DUMP TRANSFER <br /> � - • - _ __ -, ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS} FLAT-BED VAN DRUMS <br /> - v _- ❑ ❑ ❑ q <br /> FORWARD INC. LANDFILL 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 4 the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARDI <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of kts inability to accept the DISPOSE BIO AERATE JSTCCKFLE OTHER <br /> waste for any reason If Forward s refusal to accept the waste is based on <br /> weather or other site conditions Forward shalt notify the Disposer when site ❑ SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> ` REMARKS <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE. <br /> , ❑ ASH <br /> ~ ' — — ❑ OTHER <br /> lim <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL } ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFALL THE DAY BEFORE <br /> TO SCHEDULc CALL. (249) 982-4298 MANIFEST 35 <br />