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# TORW-Akt NON-HA*DOUS WASTE MANIFEST <br /> I N C O R P Q R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> Ak 'JOB`ACCEPTANCE N0,IN - <br /> GENERATOR Y „s� `�= _ REQUIRED PERSONAL PROTECTfVE EQUIPMENT <br /> -r > ❑GLOVES E]GOGGLES ❑RESPIRATOR E]HARD-HA) <br /> MAILING ADDRESS _ _4_A,-- ❑TY-VEK [:]OTHER <br /> CITY-STATE'XZIPr� + -: 5,;„�`- 'A SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> CO NTACPEF�SON aSZU_;i— rF•.�-,�. ;. ti_z - - - <br /> " l- reJr��EL.LJ <br /> SIGNAT? �RE OF AUTHOR1ZE6'AGENT%TITLEY{ <br /> RECEIVING FACIOfY <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 /> GENERATING FACIL]TY (209) 982-4298 PHONE <br /> (209) 982 - 1009 FAX <br /> �tv , ► <br /> s+ <br /> ,tjFRUCK NUMBER <br /> .ADDRESS___ w <br /> * CITY,STATE, ZIP <br /> J 1, <br /> PHONEti END DUMP BOTTOM DUMP TRANSFER <br /> E Y 7_ _,yc Clfc� ❑ ❑ <br /> SIGNATURE OeZTHORIZ2 AGENT OR DRIVER'` C?AA f s-:_-” 'ROLL-OFF(S)� FLAT BEAD - VAN DRUMS <br /> El El El <br /> FORWARD INC. LANDFILL :uslcLL <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the sate 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 5T LE 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 <br /> • conditions are expected to change such that Forward will be able to accep <br /> the waste El SLUDGE <br /> RKS-- } <br /> • REMA <br /> ❑ NON-FRIABLE <br /> EAC1LlTY TICKET NUMBER . ` ASBESTOSA.-� —..�.r.+�r�.a�i+p.�CauL <br /> ❑ WOOD <br /> S[GNATl1RE;0 TH4RfZED AG- r�� DATE. <br /> ""'�'-' <br /> El ASH <br /> G <br /> 3 OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THt DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS Al <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFOF <br /> TO SCHEDULE CALL (209) 982-4298 - 73177 <br /> 7 7 <br /> MANIFEST# <br /> _ __ _ seL=c rnev <br />