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GORWARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INE. JOB ACCEPTANCE NO. <br /> w <br /> 4211 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> V %, DE*1 BERGH FOODS COMPANY C3XLOVES [-]GOGGLES ❑RESPIRATOR BARD HAT <br /> MAILING ADDRESS ❑TY-VEK [-]OTHER <br /> 1400 W -kTER100 ROAD <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON,CA LIFOR�NIA 95408 <br /> PHONE <br /> f407146o-Q580 <br /> CONTACT PERSON <br /> FPL'%NK I ONESHIGE <br /> SIG T� E OF AUTHORIZED AGENT/ 'TITLE DAT <br /> J rnIL <br /> P&4-L <br /> •r <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> © DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> t-XO'WATFRLOO ROAD STOCKTON,C ALIFORM Lk (209) 982- 1009 FAX <br /> NAME NOTES TRU(jK NUMBER <br /> CABALLERO TRUCKING {/ <br /> ADDRESS <br /> 2530 SERRY-ESSA ROAD, = 526- <br /> CITY, <br /> 26- <br /> CITY,STATE,ZIP <br /> SAN ;OSE CA 05132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 14031 "29-0129-, ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN ORIS- — <br /> ❑ ❑ ❑ ❑ <br /> IC YARDS <br /> FORWARD INC. LANDFILL CUBS <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 SIO 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 /> [3 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 MANIFEST # C 9 0 4 2 <br /> GENERATOR COPY <br />