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O ���� NON-HAZ" '�DOUS WASTE MANIFEST <br /> FWASTE TREr,r MENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. - + <br /> GENERATOR REQ[PIED PERSONAL PROTECTIVE EQUIPMENT <br /> [� LOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS []TY-VEK []OTHER <br /> CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> 7-1!51 <br /> ' CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Q-DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ' ❑ CONSTRUCTION SOIL ❑ ASH <br /> 0 <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> /• cam- �527(,o <br /> f <br /> NAME - ,' NOTES 'y TRUCK NUMBER <br /> ADDRESS <br /> CITY, STATE,ZIP yn <br /> PHONE c I� � � END DUMP _-BOTTOM DUMP.- µ TRANSFER <br /> -_-b 9 ?,5;& - v a6�� ElEl ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> s _ �y ❑ ❑ ❑ <br /> ' FORWARD INC. LANDFILL 1~` CUBIC YARDS_ <br /> ' -So rd-sb.�ii have no-oNigaijoniQpccept the waste if weather or other <br /> conditros impair the safe-and-effectrve disposT-oT-the-waste-or r#-tbe-wasfu` DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> ' impairs a sate and effective operation of the Landfill Forward shall use <br /> reasonable eiforts 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 os based '\E <br /> fr�-�1 SOIL <br /> weather or other site conditions,Forward shall notify the Disposer when site J.J <br /> rondstions are expected to change such that Forward will be able to accept <br /> the waste ❑ LUQGE <br /> TbjMARKSNON-FRIABLE <br /> �ITY TI ET R �y � ASBESTOS <br /> j a. .� ❑ WOOD <br /> 51GNATU E � Al ORIZED AGENT <br /> i <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 MANIFEST # 2 7 9 4 3 <br /> GENERATOR COPY <br />