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ArYft ���� NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC` JOB ACCEPTANCE NO, <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> %Ati DEN BERCH FOODS COMPANY [LOVES ❑GOGGLES ❑RESPIRATOR EVARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> 1400 WATERLOO ROAD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> • STOCKTON.CALIFORNIA 115208 <br /> PHONE <br /> 12091466-9580 <br /> CONTACT PERSON <br /> FR.%"Nk YONESHIGE <br /> SIG T E OF A THORIZED AGENT I TITLE DATE <br /> * t � p�,ft• ��-t laf t <br /> ,. 'r�► �I <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 /> 1 400 WATERLOO ROAD STOCKTON,CALIFORNIA (209) 982- 1009 FAX <br /> K4�ALL,ERO TRUC'KTNG NOTES TRUCK NUMBER <br /> �_E'hYE'SS A 11101.40 QTV <br /> 041,32 <br /> pY�+4_0106 END❑DUMP BOTTOM DUMP TRANSFUK <br /> 21- <br /> SIG ALV TUFf3,E OF AUTHORIZED AGEN� OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> J <br /> FORWARD IN.��. ANDFILL 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 LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # C 9043 <br /> GENERATOR COPY <br />