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WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INS. JOB ACCEPTANCE NO. _ 1 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> S APJ DEN BERCH FOODS,COMPANY CP§LOVES ❑GOGGLES []RESPIRATOR nNARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 1-400 WATERLOO ROAD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON.CALIFORNIA 95208 <br /> PHONE <br /> f20al466-4580 <br /> CONTACT PERSON <br /> rRANK YONESHIGE <br /> SIG7UF)l OF AUTH RIZED AGENT/ TITLE DAT <br /> .. * // <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 /> I <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 1.300 IWATE RLOO ROAD, STOCKTON,CALIFORNIA (2 0 9) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> CABALLERO T'RUCKIN'G <br /> ADDRESS �. } <br /> 2530 LER.RYESSA ROAD,STE 52- <br /> CITY, STATE, ZIP <br /> • SAN IOSE CA 95132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> (4081 -29-0196 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> l ❑ ❑ ❑ ❑ <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 Lased 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 /> ASBESTOS <br /> FACILITY TICKET NUMBER <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 9044 <br /> GENERATOR COPY <br />