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WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE N0. <br /> CIM-4211 <br /> GENERATOR REOUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> VAN DEN BERGH FOODS,COMPANY LOVES [:]GOGGLES ❑RESPIRATOR OAARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> 1 400 WATERLOO ROAD <br /> CITY, STATE ZIP SPECIAL HANDLING PROCEDURES <br /> STOCKTON CALIFORINIA 95208 <br /> PHONE <br /> (2{9)4o0-0580 <br /> CONTACT PERSON <br /> FRANK YONESHIGE <br /> SIGNATUIRE OF AUTHORIZED AGENT 1 TITLE DATE <br /> ,k W&KZ 5)�q_r <br /> H <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> Q DISPOSAL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ <br /> CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 140 WATERLOO ROAD, STOC KTON,CALIFORNIA (2 0 9) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> CABALLERO TRUCKING <br /> ADDRESS y <br /> 2530 BERRYESSA ROAD,STE 52— <br /> CITY. STATE,ZIP <br /> SAV JOSE,CA 95132 <br /> PHONE ENDDUMP BOTTOM DUMP TRANSFER <br /> ,403) '20-0190 IT <br /> SIGNATURE OAUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS N <br /> FORWARD INC LANDFILL CUBIC YARDS 1 <br /> Forward shall have no obligation to accept the waste if weather or other r <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 810 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 sate ❑ 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 9046 <br />