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� ¢ FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> dh JOB ACCEPTANCE N0, 95.1000 <br /> GENERATOR REQUIRED PERSONAE:'PROTECTIVE EQUIPMENT <br /> ❑GLOVES [:]GOGGLES ❑RESPIRATOR ❑BARD HAT <br /> ,MAILING ADDRESS' S ❑TY-VEK ❑OTHER <br /> ` Yr STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> t <br /> • <br /> 'PHONE <br /> ,CDRIACT PERSON <br /> SIGNATU11F,OI,'AUTHORIZE14 AGENrz TITLE 'DATE <br /> 1W, TYPE' RECEIVING,FACII ITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> ;GENERAPNIS FACIUTY =� , (209) 982-4298 PHONE <br /> ' (209) 982- 1009 FAX <br /> NAME = TRACTOR LIC # TRUCK NUMBER-,` <br /> I ADDRESS TRAILER LIC # <br /> , s <br /> . C1TY,iSTATEr.AP, TRAILER LIC # ' s <br /> ` <br /> PHONE END DUMP BOTAN <br /> TOM DUMP _TRSFER <br /> , :, ; <br /> ❑ ❑ ❑ <br /> • S,km-r0np OF ACJ;TF,iORIZED AGENT OR DRIVER = ' DATE BOLL-OFF($) FLAT-BED VAN 'DRUMS <br /> ❑ ❑ ❑ ❑ <br /> I FORWARD INC. LANDFILL ,Cl,BIC,YtDs <br /> Forward shall have no obligation to accept the waste if weather or other r� <br /> conditions impair the safe and effective disposal of the waste or if the wasteDISPOSAL METH00. SIO B1=,CIDMRIxI»T1=D'BY FORWE1R <br /> impairs the safe and effective operation of the Landfill Forward shall use ,E s ° ', <br /> Dy <br /> reasonable efforts to promptly notify Disposer of its inability to accept the t r, DISPOSE 810` IAERATE $T€ KPILE ' OT�112141 <br /> waste for any reason If Forwards refusal to accept the waste is based on _ ❑ SOIL <br /> weather or other site conditions, Forward shall notify the Disposer when site <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste y ❑ SLUDGE <br /> ` =R`M�l•'""'33=I Er S�,E13{�i Ir 1=f �I fsf j ri! i! S , = I 7 7 1 '�I I � € 4 t i ` t <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> ❑ WOOD <br /> E <br /> !SlGj A;I4R,° 'OI,IAUTHOFIZED"AGC-NT ;E' , 's`' [SATE� <br /> - r ❑ ASH <br /> y f f <br /> 'r' 't ❑ OTHERI I L <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 <br /> F01{G9511NHl6 96 <br /> sof FS rnpv MANIFEST # C ;�?� <br />