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I �5 • j 1 NON-HAS 'RDOUS WASTE MANIFEST �►� i C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY T JOB ACCEPTANCE NO. �� - r GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT [-]GLOVES ❑GOGGLES []RESPIRATOR [:]HARD HAT tMAILING ADDRESS ❑TY-VEK []OTHER 6737' E P13v.w-;,y SPECIAL HANDLING PROCEDURES CITY STATE,ZIP • Se kc�.n C - PHONE z�9 9 31' 3 70 CONTACT PERSON , L,*fly Mn o SIGNATURE OF AUTHORIZED AGENT / T Ll DATE 5E~ - ' WASTE TYPE RECEIVING FACILITY ' "0r ❑ SLUDGE TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH s ' • � OTHER s-1 MANTECA, CALIFORNIA 95336 GENERATING FACILITY (209) 982-4298 PHONE (209) 982- 1009 FAX NAME NOTES TRUCK NUMBER', �{ 9 ea53� ADDRESS • CIN,STATE, ZIP PHONE END DUMP BOTTOM DUMP TRANSFER zcrl z S 4 v ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS FORWARD INC. LANDFILL CUBIC YARDS � / ' Forward shall have no obligation to accept the waste if weather or other r �! conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) impairs the safe and effective operation of the Landfill Forward shall use reasonable efforts to promptly notify Disposer of its inability to accept theDISPOSE BIO AERATE STOCKPILE OTHER waste for any reason If Forwards refusal to accept the waste is based on SOIL weather or other site conditions, Forward shall notify the Disposer when site conditions are expected to change such that Forward will be able to accept the waste ❑ SLUDGE REMARKS NON-FRIABLE ❑ ASBESTOS FACILITY TICKET NUMBER ❑ WOOD SIGNATURE OF AU ORIZED AGENT L�1- 7_ [:1 ASH * S ❑ OTHER t ` SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE TO SCHEDULE CALL(209) 982-4298 MANIFEST # 092844