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FORWARD NON-HAZARDOUS WASTE MANIFEST INCORPORATED- WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE N0, �/�= _7 NERATORREQUIRED PERSONAL PROTECTIVE EOUIPMENT �" J;� (r t �' �fi [�fLOVES ❑GOGGLES []RESPIRATOR [� ARD HAT MAILING ADDRESS 1 ❑TY-VEK []OTHER CITY, STATE,ZIPr r �� r / SPECIAL HANDLING PROCEDURES PHONE s ,r CONTACT PERSON —� SIGNATURE OF AOfHORIZED AGENT/TITLE DATE , WASTE TYPE RECEIVING FACILITY ❑ SLUDGE ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATINGFACILITY 1 (209) 982-4298 PHONE - (209) 982 . 1009 FAX E --;- �, NOTES TRUCK NUMBER ADDRESS . CITY, STATE,ZIP • PHONE END DUMP BOTTOM DUMP TRANSFER bl ❑ ❑ SIGNATURE OF AUTHORIZED AGENT OR DR;VER DATE ROLL-OFFS) FLAT-BED VAN DRUMS FORWARD INC. LANDFILL CUBIC YARDS` Forward shall have no obligation to accept ,tie waste if weather or other ` condfions impar the sale and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) impairs the safe and effective operation of the Landfill Forward shill ase reasonable efforts to promptly notify Disposer o' its inability to accept ther DISPOSE BIO AERATE STOCKPILE OTHER v,aste for any reason If Forwards refusal to accept the waste is based on {'SOIL weather or other site conditions,Forward shall noa`y the Disposer v hen site conditions are expected to change such that Forward will be aide to accept the waste ❑ SLUDGE REMARKS NON-FRIABLE FACILITY TICKET NUMBER ASBESTOS ❑ WOOD ; NATURE OF AUTN ORIZED AGENT DATE , Iron( r ❑ ASH 7�C ' i ' `- , '""I # ! / ❑ OTHER ML I SCHEDULING MUST BE MADE PRIOR TO 4 00 P M. THE DAY PRIOR TO EXPECTED ARRIVAL + ANY UNSCHEDULED LOADS ARE IUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. O SCHEDULE CALL (209) 982-4298 MANIFEST # 79294 xN-=>cY