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� l <br /> (trFORWARV l NON-HASDOUS WASTE MANIFEST <br /> INCORPORATED ! WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. -j' <br /> GENERATOR _ x,_ _ ?:` ,;.: �_ �` REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> lej 7.r ❑GLOVES []GOGGLES []RESPIRATOR []HARDHAT <br /> MAILING ADDRESS�- 'r ; r° � � ❑TY-VEK ❑OTHER <br /> r~` •`�`'�y } 15 ~ - — - SPECIAL HANDLING PROCEDURES <br /> CITY STATE,,ZIP <br /> row <br /> (St[a�_ <br /> COi77�TAC PERS( <br /> �f � <br /> SIGNATURE OF 6UTHORIZ Q&kGENa4,,nTLE�,� DA�E���- <br /> _err- -- <br /> i K`SS..w '_+,"4,'.h`•� l g 'r R,`x , ..rn ._—e• "''`.t <br /> WASTE TY a rte,-.:rrY _' 7 _.3sx �'t` "'"s�` ' _S,: RECEIVING.FACI -Y L-,,.SLUDGE <br /> 1 <br /> ❑ TREATMffNTSOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL;SOIL ❑ WOOD Jg999 SOUTH AUSTIN ROAD <br /> ❑ <br /> CONSTRUCTION SOIL ❑ ASH J, ?-}C <br /> El OTHER ; MANTECA, CALIFORNIA 95336 <br /> GENERATINGFACILI Y (209) 982-42J8 PHONE <br /> 3 <br /> (209) 982- 1009 FAX <br /> J11�rA:Z !_ <br /> NAME Zc_,TR_IJCC}CPIU V�IBER.d._ <br /> ADDRESS-Fw •: x..- y,- fr a' J « �T <br /> . CITY ATATE,'ZIP: ' _ _ . _ �` ' T 5 <br /> PHONE „END DUMP u.M y BOTTOM DUMP TRANSFER <br /> �§IGNATUR OF A TH -IZED AGENT OR DRIVER' D_ATff s ' i ' ROLL-OFF(q).- FLAT-BED-,-; VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC Yens :;- � 7 -�W � � �-�= <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 useA <br /> reasonable efforts to promptly notify Disposer of its inabldy to accept the - DIS OBI' BIO , AERATE STOCKPILE OCHER <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 /> + t' :s;.j--LA-1, 2V --stir. . <br /> R�MARICS aS-KE5.-_'y--r_.Z_ `v�`Er .:y NON-FAIABLE <br /> � ASBESTOS <br /> FACIUjEj1CKET NUMit IN -r, � _,- _- F�wx;; .:._ <br /> -� ❑ WOOD <br /> SIGNATURE,- _AU;TIIORIZffD 41V1 DATE ,r � <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS AR <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DRAY BEFORE <br /> TO SCHEDULE CALL (249) 982-4298 MANIFEST# 68001 <br /> SALES COPY <br />