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iFvR Y ARD - NON-HAZARDOUS WASTE MANIFEST 1 V C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY JOB ACCEPTANCE N0. L 7 �j Y;. 71 GENERATOR t --tv-1W" fr REQUIRED PERSONAL PROTECTIVE EQUIPMENT i' GLOVES ❑GOGGLES ❑RESPIRATOR D'HARD HAT ]LING ADDRESS 17 1 r ❑TY-VEK [:]OTHER CITY, STATE,ZIP SPECIAL HANDLING PROCEDURES "'L ! !7_t ' - PHONE / CONTACT PERSON ' SIGNATURE, 1Oi=AUTHORIZED AGENT/ TITLE DATE I �'1 R• � if_+r- � w WASTE TYPE RECEIVING FACILITY ❑ SLUDGE TREATf✓ENT SOIL ❑ • ❑ DISPOSAL SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ WOOD ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ OTHER MANTECA, CALIFORNIA 95336 GENERATING FACILITY _ (209) 982-4298 PHONE (209) 982- 1009 FAX tV1E —fir r NOTES TRUCK NUMBER f ADDRESS - CITY, STATE, ZIP^ _ PHONE END DUMPBOTTOM DUMP TRANSFER ❑� ❑ SIGNATURE O]=i,AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS FORWARD INC. LANDFILL CUBIC YARDS,—, f v Fori,arc[shall have no obligatoon to accept the waste if weather or other ` conodtons impair the safe and e'fective disposal of the v.asle or if the wasteFDISPOSAL 4 impairs the safe and effective operation of the Landfill Forward sha+l use ETHOD (TO BE COMPLETED BY FORWARD) reasonable efforts to promptly notify Disposer of ds inability to accept theDISPOSE BIO AERATE STOCKPILE OTHER waste for any reason If Forwards refusal to accept the waste is based on weather or o,her site cond+trons Forward shall notify the Disposer when site conditions are expected to change such that Forward will be able to accept the waste REMARKS A ❑ SLUDGE ❑ NON' FRIABLE - FACILITY TICKET NUMBER l f ASBESTOS �SIGNA7URE OF AUTHORIZED AGE �T� �� DAPE VVOOD_ \\ Lt ❑ ASH ' ❑ OTHER WL= SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL * ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE 10 SCHEDULE CALL, (209)982-42913 MANIFEST # 79292 929rG3