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WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> I ffv_-Ara'V TWASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE N0. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> DEN 13ERGH FOODS,COMPAN't E3NLOVES ❑GOGGLES ❑RESPIRATOR ❑MARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 1.100�k ATF RLOO RO-LD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON.CAIAFOWNIA 95208 <br /> - PHONE <br /> 20a 466-9580 <br /> CONTACT PERSON <br /> riL\1NK YONESHIGE <br /> SIG71 E OF A THORIZED AGENT / TITLE a 75-k!5— <br /> � "I ��zf <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1300 W ATE RL00 ROAD, 'STOCKTON- C ALIFORINI a (2 0 9) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> C-XBALLER(D TRUCKING <br /> ADDRESS <br /> 2530 BERRYESSA ROAD STE 527 <br /> . CITY, STATE, ZIP <br /> • SAV JOSE CA 95132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 408 s '1 -0106 1;1 ❑ ❑ <br /> SIGNATURE F AUTHORIZED AGENT 05,DRIVER DATE ROLL-OFF(S) 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 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 Q 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL 0 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 9041 <br /> GENERATOR COPY <br />