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WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC' JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> VAN DE',"'I3ERGH FOODS,COMPANY CLOVES [:]GOGGLES ❑RESPIRATOR ERdARD HAT <br /> MAILING ADDRESS ❑TY-VEK [-]OTHER <br /> 1400 WATERLOO ROAD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> STOCN,C.A.LIFORNIA 95208 <br /> PHONE <br /> (209)46o-9580 <br /> CONTACT PERSON <br /> FRANK YONESHIGE <br /> SIGN OF AU ORIZED AGENT / TITLE DATE <br /> _?e . '%— 04 a/k P-.T - <br /> WASTE TYPE RECEIVING FACILITY <br /> i ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION 501E ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 400 WATERLOO ROAD STOCK70N,CALTFORNLA (2 0 9) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> CABALLERO TRLCKrNG <br /> ADDRESS <br /> 2530 BERRYESSA ROAD STE 52- <br /> CITY, STATE, ZIP <br /> • SA*t JOSE,CA 95132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 408) -20-0196 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUM _ <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 /> FACILITY TICKET NUMBER ASBESTOS _ <br /> ❑ WOOD <br /> _ SIGNATURE OF AUTHORIZED AGENT DATE <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 /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE MANIFESTLANDFILL <br /> E DAY g 0 3 9RE <br /> 70 SCHEDULE CALL(209)9$2-429$ <br /> GENERATOR COPY <br />