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WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> ff'r_V_Mff2 WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE N0. <br /> w <br /> 4211 <br /> GEN BATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ', l'1 D£'1. BERC.H FOODS,COMPANY [LOVES E)GOGGLES ❑RESPIRATOR C3MARD HAT <br /> MAILING ADDRESS [:]TY-VEK []OTHER <br /> 400«'ATERLOO ROAD <br /> CITY STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> T OCKTON,C-%LIFOR—NIA 95208 <br /> PHONE <br /> _0Q),16o-35R0 <br /> CONTACT PERSON <br /> I :Lk.i K 'i ONESHIGE <br /> SIGATIlJ E OF AUT ORIZED AGENT / TITLE DATE <br /> ��6rl <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> - ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> *400 WATE=RLOO ROAD STOCKTON C.ALIfORNL.56 (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> AB ALLFRO TRL Ck NG / <br /> ADDRESS r/ <br /> 'f30 ROAD STE Sy' <br /> . CITY,STATE, ZIP <br /> JAS IOSE C a 35132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> "MR) -"9-t3ino ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> �_-, ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> iForward shall have no obligation to accept the waste it weather or other <br /> conditions impair the safe and effective disposal of the waste or it the waste DISPOSAL 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 DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site ❑ SOIL <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 TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> 1 ❑ 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 MANIFEST # C 9030 <br /> GENERATOR COPY <br />