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+ORWARO NON-HAORDOUS WASTE MANIFEST <br /> �►� INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTAJNCE H0. <br /> P21.) <br /> '� "� <br /> r <br /> GENERATOR - ,,_ ,;"r,r,>�';-� ��w },' REQUIRED PERSONAL PROTECTIVE EQUIPMENT YL, <br /> ❑G!_OVES ❑GOGGLES ❑RESPiRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [-]OTHER <br /> y SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZIP <br /> PHONE- <br /> .C.S 14.E� Cr_i 7 A,�SUC� ,.�.�,��...,;.,r f�.•��'.`�--.::tea.-,� <br /> CONTACT PERSON <br /> c` <br /> SIGNATURE`OF AUTHORIZED AGENT,_Tf1' AT A-7- <br /> WASTETYP �"ysi :ti ,_ r:ab'�" t <br /> ..ECEIVi�VG FACILITYH�� �.�,:�,.�'t.•,�._ <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS, FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER - MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY- ;, (209) 982-4298 PHONE <br /> (209) 982-- 1009 FAX <br /> STJL C ►'1 [- <br /> NAME " ' OTE3� � , U _ NUMBMy4. _ � i'� R <br /> !1 J!Z"i ICI��f f�/e l� 1 l�� -�_:;�F'• "r` -- �wx�1 / lJ <br /> ADDRESS _ <br /> * CITY,STATE,ZIP <br /> PHONE - _ _ _ N END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTF RIZED AGENT OR DRIVER DATE ROLL-OF �S)� FLAT--BED g����i VAN -DRUMS <br /> El <br /> CUBIC Y <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impar the safe and effective disposal of the waste or if the waste C!SPOS METHOD (TO BE COMPLETE 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 ; AER_ATE ST LE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on - <br /> weather or other site conditions Forward shalt 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 - `" � _, . _ �-�-- x�- r�--�..-_-�•� <br /> NON-FRIABLE <br /> • ❑ ASBESTOS <br /> ACIDITY TICKET NUMBER <br /> ❑ WOOD <br /> --- _ ❑ ASH <br /> �C L_ <br /> ❑ OTHER <br /> SCHEDUL190 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# 68002 <br /> SALES COPY <br />