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WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INE. JOB ACCEPTANCE NO, CMM <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> %AN DEN BERGH FOODS,COMPANY LOVES ❑GOGGLES ❑RESPIRATOR C2VARD HAT <br /> MAILING ADDRESS _ ❑TY-VEK ❑OTHER <br /> 1400 WATERLOO ROAD <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> S rOCKTON,CALIFORI IA 95203 <br /> PHONE <br /> (209) n6-QS40 <br /> CONTACT PERSON <br /> FR.VNk YGNESHIGE <br /> SIGN,�Up OF AUT ORIZED AGENT/ TITLE DAT9 <br /> L <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> * Q DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASN <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 3 100 �'� ATFRLOO RO-1D STOCKTON CALIFORNIA (209) 982- 1009 FAX <br /> NAME NOTES TRUCK NUMBER <br /> ,-'ARALLERO TRUCKING <br /> ADDRESS <br /> 2=30 SERRYESSA ROAD, STE 52" <br /> . CIT`, STATE,ZIP <br /> S-�,N fOSE.CA 95132 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> -^_91-0 <br /> , 1:1 E]�C3� h_��-O 10(3 <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS - M <br /> f ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other / 8 <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 <br /> GENERATOR COPY MANIFEST # C 9048 <br />