Laserfiche WebLink
FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> I N C U R P 0 R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0, � ;'� -- - <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT _ _ <br /> F]GLOVES n <br /> MAILING ADDRESS '.� , r - ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ', _ _ - ❑7Y-VEK ❑OTHER <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> - - <br /> '^tY <br /> * <br /> W <br /> - PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE- DATE <br /> .. * . . v <br /> WASTE TYPE j - - - RECEIVING_FACILITY_ <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL [:1 WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ,❑ OTHER <br /> MANTECA, CALIFORNIA 95336 <br /> GENERATING (209) 982-4298 PHONE <br /> - - - <br /> t (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER r <br /> a _ - <br /> ADDRESS <br /> CITY STATE, ZIP <br /> PHONE_ <br /> �w END=r � _ _ _" '' AUM#PBOTTOM DUMP TRANSFER <br /> P _ . <br /> SIGNATURE DUMP- <br /> AUTFiORIZEDS AGENT OR DRIVER�- DATEY ROLL-0F (S) _vM FLAT-BED 1 VAN ^- a DRUM$ <br /> El 0 <br /> FORWARD INC. LANDFILL CUBIC,YARDSx_ , T fi ti _w , <br /> Forward shall have no obligation to accept the waste if weather or other iF 1� a <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 -DISPOSAL METHOD (TO BE COMPLETED BY FORWARD.p <br /> reasonable efforts to promptly notify Disposer of its inability to accept the IDISPOSEI 810 i AERATE IST-OCKPILE _OTHER <br /> waste for any reason If Forwards refusal to accent the wade .s bred o^ " t - <br /> weather or other site conditions Forward shall notify the Disposer when site ❑ SOIL <br /> ' <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste El SLUDGE <br /> REMARKS <br /> _ -- ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER _ ASBESTOS <br /> - ❑ WOOD <br /> IGNATURE OF AUTHORIZED AGENT DATE� r <br /> _^ ❑ ASH <br /> ❑ OTHER <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 LANDFILL THE DAY BEFORE, <br /> TO SCHEDULE CALL (209)982-4298 <br /> MANIFEST # t t� <br /> GENERATOR COPY <br />