Laserfiche WebLink
.� WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> F <br /> C. JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT-: <br /> MAILING ADDRESS �puSl. ❑GLOVES []GOGGLES ❑RESPIRATOR JHAR HAT <br /> ❑TY-VEK ❑OTHER <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> * PHONE <br /> �j HiQ x'66 <br /> CONTACT PERSON' <br /> �Fi r�_ YAlt1��E 1~ <br /> SIGNATUR,E..OF AUTHORIZED.AGENT/,TITLE { ` ' DATE <br /> + WASTE TYPE <br /> RECEIVING FAC <br /> ILfTY <br /> I <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 /> GENERATING FACILITY (209) 982-4298 PHONE <br /> ID V/1 (209) 982- 1009 FAX <br /> erg- <br /> NAME I , NOTES: TRUCK NUMBER <br /> ADDRESSC/t— �OA,0 l . <br /> . CITY, STATE,ZIP <br /> . PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> / �} ❑ ❑ El El <br /> FORWARD INC, LANDFILL <br /> CUBIC. <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 if the waste p S AL METHOD: (TO BE.COMPLETED.BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the OSE 13tO,t:; AERATE ISTOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site IL <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 TICKUfV�13Efl� ? <br /> ��// ❑ WOOD <br /> SIGNATU OF HORI77¢D AGENT DAT <br /> `T- E <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR <br /> TO P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL OING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE`CALL(209)982-4298 MANIFEST # 4 9 V 0 4 <br /> GENERATOR COPY <br />