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WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISP6SAL FACILITY <br /> 11L�IC. JOB ACCEPTANCE NO, <br /> GENERATOR <br /> n REQUIRED PERSONAL.PROTECTIVE EQUIPMENT <br /> �✓ � � t ���1 f� �5�( `~ ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING AD KESS ^y ❑TY-VEK ❑OTHER <br /> P,0. �F <br /> CITY,STATE, ZIP " SPECIAL HANDLING PROCEDURES: <br /> /�r <br /> PHoNE CO/1 '64- �SbC� <br /> 3 <br /> ti° ri <br /> CONTACT. R ON, <br /> 4�;617e_6 T- <br /> SIGNATURE OF AUTHORIZED AGENT/:TITLE DATE <br /> WASTE TYPE <br /> RECEIVING FACILITY ''r.., a <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 /> .�?/o LA S-7-f+ -St- <br /> (209) 982- 1009 FAX <br /> C�- <br /> NAME: T <br /> NOTES: RUCK NUMBER <br /> ADDRESS l <br /> CITY,STATE,ZIP 3` ` <br /> PHONE S$ END DUMP - BOTTOM DUMP .TRANSFER <br /> Q% 2f-- Gi/DU FL] ❑ ❑ <br /> SIGNATURE OF AUTHORIZED.AGENT,OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> CUBIC A <br /> FORWARD INC. LANDFILL <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 ;DISPOSAL MET D: (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall usereasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE 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 siteOIL <br /> conditions are expected to change such that Forward will be able to acce <br /> the waste. ❑ SLUDGE <br /> REMARKSo <br /> f NON-FRIABLE <br /> ASBESTOS <br /> FACILITY T KFS/NUM ER l <br /> ,;;. <br /> l i ❑ WOOD <br /> SIGN RE f A HORIZ AGENT DATE <br /> J/ / ❑ ASH <br /> __� �� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4: .M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE r <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOfNG DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. l <br /> TO SCHEDULE CALL(209)982-4298 GENERATOR COPY 4 9 611 <br /> MANIFEST# <br />