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IFORWARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC'' JOB ACCEPTANCE N0. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> � AIN DE:i BERGH FOODS,COMPANY [LOVES [:]GOGGLES ❑RESPIRATOR [SbdARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> 1400 WATERLOO ROAD <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON,C ALIFOR-NIA 95209 <br /> PHONE <br /> ` <br /> (209466-9590 <br /> CONTACT PERSON <br /> FRANK YONESHIGE <br /> 51G�A7�yU E OF A THORIZED AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • p DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> F-1CONSTRUCTIONSOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1400 WATFRI,Oo ROAD STOCKTON.CALIFORNIA (2 09) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> C ABALLFRO TRI-CKING <br /> ADDRESS <br /> 30 BERRYESSA ROAD,STE 52- <br /> CITY, STATE, ZIP <br /> SAN JOSE,CA 95132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> f40Ra 0-0196 Q_ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BEE)r VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <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 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 />' SIGNATURE OF AUTHORIZED AGENT DATE E] WOOD <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 />' SU JECT TO EREFUSAL UPON CALL(49)982-4298 AONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> GENERATOR COPY MANIFEST # C 9035 <br />