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NON-HAZARDOUS WASTE MANIFEST - --i. <br /> F;SR-WARD ' WASTE TREATMENT AND DISPOSAL FACILITY <br /> QIIVC. JOB ACCEPTANCE NO. 7� <br /> GENERATOR: x <br /> +; _ REQUIRED PERSONAL PR_OTECTIVE'EWUIPMENT <br /> U Ti 7 a(�cJ�� ❑GLOVES [ GOGGLES [ RESPIRATOR (]HARD HAT ' <br /> MAILING ADDRESS. / '' �;. ❑TY-VEK ❑OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY;.STATE, ZIP (' > <br /> PHONE A <br /> n C <br /> tt CONTACT PERSO <br /> SIGNATURE OF AUTHORIZED AGENT/ TIT'LE DATE �r <br /> Co <br /> n WASTE TYPE RECEIVING FACILITY ^`' _. .'. . ._ ' . " _r- .l <br /> ❑ SLUDGE <br /> F1 TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ° <br /> DISPOSAL SOITIO ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> A <br /> GENERATING FACILITY (20. 9);982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME }. ..N���cS�.,.�� ��Y p--j{ 1 . .TRUCK Nt�BER .•: <br /> ,4DDRES8. .ji. jr =S y. ' <br /> "- CITY,STATE, ZIP •[^ <br /> PHONE •'�� 7 END DUMP BOTTOM DUMPS ;R TF N§FV EFt <br /> SIGNATU F AUTHO AGENT OR DRIVER DATE ROLL-OFF •5i' <br /> ( � _ ,tFLAT BEp�` ��NA�I � �N <br /> DIMSTM`rT� <br /> El El 11 <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if weather or other 's <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL.METHOD x -.,(TO BE COMPLET�D'I Y.;FORWARD). <br /> impairs the safe and effective operation of the Landfill. Forward shall use 1• s, <br /> tt reasonable efforts to promptly notify Disposer of its inability to accept the ?� _ TR DtSPO_SE 910 AERATI- STOCKPILE OTHERT,s <br /> waste for any reason. If Forward's refusal to accept the waste is based on �1 <br /> R SOIL <br /> weather or other site conditions, Forward shall notify the Disposer when site uct <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> 'RE�11lA�ilt5. /(Jil�� JC Y77 <br /> rte- <br /> ■ "" NON-FRIABLE <br /> ❑ ASBESTOS <br /> .FACILITY,TICKET..NUMBEW <br /> , i L�� ❑ WOOD <br /> SfC3FAYURE OF <br /> AUTHORIZE AGENT` DATES `µ <br /> ❑ ASH <br /> ' ( �� ❑ OTHER <br /> StatIF.I tUTAVG MUST' 13F MAf)f= rrK)n 'To i:UU P.ri1- Tf'IE DAY PPIOR '10 EXPE(JED ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> SI If.-1F,(.,T TO T;I=t"t_).`=AI..t11'Qf I AIIIIIVAI. OrtGOUJ(;IJAILY DF.L.IVERIES MUST PE SCI IEL)Ul_Ff] W11111 TME LANDFILL THE DAY BEFORE. <br /> T() C301lfCr ULF_ CALL (209)902-4298 <br /> MANIFEST # 6650 <br /> 6 5 <br /> r;UIFFIATOR COPY 4, <br />