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WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC_ JOB ACCEPTANCE N0. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> N'A,N4 DEN BER GH FCODS,COMPANY ®r.LOVES E❑GOGGLES ❑RESPIRATOR Cg EiARD HAT <br /> MAILING ADDRESS ❑TY VEK [-]OTHER <br /> 1.100 WATERLOO ROAD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON CALIFORNIA 0520$ <br /> PHONE <br /> ` <br /> t2091-466-9580 <br /> CONTACT PERSON <br /> 1-°ANK YONESHIGE <br /> SIGIN6_0 OF AU ORIZED AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> EE] TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> * DISPOSAL SOIL ❑ wooD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> E J00 W A ERLOO ROAD, STOCKTON,CALIFORNIA (2 0 9) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> CABALLERO TRUCKING <br /> ADDRESS <br /> '2530 BERR.'ESSA ROAD,SI'E 52' <br /> . CITY, STATE, ZIP <br /> SAN JOSE CA Q5132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> '408) -29-0190 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGEN OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 Forward's 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 LANDFILL THE DAY BEFORE <br />' TO SCHEDULE CALL(209)982-4298 GENERATOR COPY MANIFEST # C 9040 <br />