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() �' l UKWAaK1J NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO <br /> • 002k1_11ii" <br /> GENgMTQR'+�-y <br /> !'- " C Y' ❑GLOVES ❑GOGGLES [:]RESPIRATOR ❑HARD HAT <br /> MAILENa A _PEW2 x ;� ❑TY-VEK []OTHER <br /> CITY STATER Z3P 7 r ;i '�{; s f;- a _Nom"-, :` � SPECEAL HANDLING PROCEDURES <br /> _ - y <br /> • t�4{s t � � I"Y�'z�� <br /> PHONE- =' F° CS <br /> yh v_Y.Y.._' y c rV✓�: 4; ,g'�- Cy(, <br /> coNTACT PER8o ''.�._` �.c T,�, ca;� �, '�; &e-t�v'�• �/C){�� � W <br /> SIGNATURE pF AUTHOR#ZED AGEN"I'%,TITLE ,z�'�. DA CC <br /> WASTE TYPE L� . RECEIVlN f�. <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL [] WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ' '❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • <br /> (GENERATING FACiLU,y$- 'A j" sY^ �'� '� _ 209 <br /> . `4_ w _- F=. ° -, ) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME,.. ';� � � � � t��� �.�a„ r � �a �'IVCY3F8•.-�.rx=���4�g -�” -,'- .�... <br /> .. TRUCK NUMBEFr' <br /> 1 <br /> ADDRES <br /> PHOE .sem � rA , - s� r a` ,= ENQ DUWIP �� a, BOTTOM DUMP, TRANSFF <br /> ria fi max. <br /> S_r��`.a L.. A.a.ie<W. 51-Mo-a.A`�' w -.-h__r s Sv.4 n -' ..5L�.{...^j.YS��R.-.w .•"i�=F..-..r W .ws fir`. 1 <br /> SIGNATUNE O'AUTFiORIZED'AGEN C,OR DRIVER k DATE�� . �?ROLF <br /> DR <br /> El <br /> E3 <br /> _ AIS UIG(S <br /> 7k ❑ ❑ <br /> FORWARD INC. LANDFILL CEIB1, .RDS <br /> A <br /> Forward shaft 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 D T <br /> MEHO <br /> DISPOSAL - <br /> impairs the safe and effective operation of the landfill Forward shall use 1.�.r�.P„-�;,, ,E O .(70 BE COMPLETED BY FO <br /> `- <br /> reasonable efforts to promptly notify Disposer of its inability to accept thaAERATE S1i7C <br /> waste for any reason If Forwards refusal to accept the waste is based on ' <br /> r es�hti'or other site conditions,Forward shall notify the Dispose, when site ❑ SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> ` the waste - _ ❑ SLUDGE <br /> REMARiGS�` - <br /> ._.. NON <br /> y ❑ -FRIABLE <br /> FACT —= r ASBESTOS <br /> LITY 7ICKETwNIJI;i@ER 5 r�- _ _ _ _ -` � �{ <br /> j ❑ WOOD <br /> SIGNATURE QF AUTWftIZED AGENT,- _ _ DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL 0 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 /> MANIFEST # <br /> GENERATOR COPY <br />