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NON-HAZARDOUS WASTE MANIFEST <br /> WA <br /> RD WASTE TREATMENT AND DISPOSAL FACILITY <br /> At <br /> JOB ACCEPTANCE NO. — <br /> GENERATOR."; .; REQUIRED PERSONAL-PROTEGIIUEEQUIPMEN p '" <br /> []GLOVES []GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING.ADbRESS I } t { ❑TY-VEK ❑OTHER <br /> CITY STATE,ZIP �. - `° ._ w ti. SPECIAL HANDLING PROCEDURES: <br /> 1 -.t t 1 pA -5 .. <br /> 0 / ISL�! �•//� C//QJ <br /> PHONE <br /> x Zoe 473 - z� �3 l <br /> t� 'CONTACTPERSON:' <br /> i <br /> '� SIGNATURE OF,4UTHORfZED AGENT / 71TLE y. DATE <br /> ie WASTETYPE _ .. .y r'.r� ren• :�� _ .,J. ;�- RECEIVING.FACILITY, <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> -DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ;d ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> AME NOTES: _ -4 _� TRUCK V MBEff i <br /> ' ADbRESS <br /> CITY STATE,.ZIP <br /> PHONE ° . END DUMP. BOTTOM.DUMP TRANSFER <br /> S1GN,ATl11 tE OF AUTHORIZED AdffifOR DRIVER. DATE 'ROLL OF=F(S) q„ -„FLAT-ICED r,VAfJ_,�. [3RUMS <br /> �C <br /> cuBlc vARDs.:,w <br /> FORWARD INC. LANDFILL <br /> Forward shall have no obligation to accept the waste if 0--ather or other U <br /> conditions impair the safe and effective disposal of the waste or if the waste 'DISPOSAL METHOD: <br /> (TO'RE COMPIL.ETEb B FQFWARD};: <br /> impairs the safe and effective operation of the Landfill. Forward shall use :�A• _41 � ., � �s � . <br /> >? teasonable efforts to promptly notify Disposer of its inability to accept the. ? <br /> DISPOSE SID AERATE $1OCKPILE OTHER", <br /> waste fot any reason. If Forward's refusal to accept the waste is based on E] SOIL <br /> �. <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 accept <br /> the waste ❑ SLUDGE <br /> REMA <br /> NON-FRIABLE <br /> C" /G' C Z C(_��' Z S C ❑ ASBESTOS <br /> 'FiACILf f;Y TICKET NUMBER <br /> ` 0 WOOD <br /> SIGNATURE OI^•AU�' IZED'AGENT DATE- <br /> � .-�- �' : [:] ASH•.... <br /> �.) <br /> r <br /> •+ •t-= ❑ OTHER <br /> SCIIEl1t,l9_Ir1G Ml-l!-,-T fiF fAA1717 PRIOR l() 4:00 P.M. 111E DAY F`f;IVfi TO EXPFCIF_0 AFIRIVAI_ ^ ANY UNSCIIEDULED LOADS IIFIE <br /> t1Ff"U nt-.UPON ARIMIAL. (41GOING,P rlY rlt:;f_tV[-f'Ir.^M ',F Ur- .3cl Ir-DUP-0i %.A1I ITI TIME LANDFILL THE D" REFORE. <br /> 10 FC'1IRDULF CALL (709)9B?.-42913 �8 <br /> MANIFEST# <br /> 111AMS120Mr-,n cart <br />