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FORWARDNON-HAZARDOUS WASTE MANIFEST <br /> ' <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NC, 745711 - <br />' ENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> .P revrk= ®GLOVES ❑GOGGL.ES [:)RESPIRATOR ©HARD HAT <br /> ILING ADDRESS ❑TY-VEK ❑OTHER <br />' 2151 Nally Dmti <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> « 5'tc:k3 CA 45206 <br /> - PHONE <br /> CONTACT PERSON <br />' SIGN'ATUR pF AUTHORIZED AGENT/TITLE DATE <br /> tWASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br />' ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • fl DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION! SOIL ❑ ASH ASH <br />' ❑ STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br />' ME TRACTOR LIC ��% j4% —" TRUCK NUMBER— <br /> "ZfADDRESS TRAILER LIC # /� I <br /> CITY, STATE,ZIP TRAILER LIC # <br /> PHONE END DUMP BOTTOM DUMP : TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DACE R0LL-OFF(S) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> r- <br /> Forward shall have no obligation to accept rhe waste if weather or other <br /> cono4ions impair the safe and effect:ve disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD <br /> Impairs the safe and effective operation of the Landfill Forward shall use - ! ) <br /> reasonable efforts to promptly notify Disposer of its inability to accept the /4 - <br /> "asie for any reason if Forwards refusal to accept the waste is based on DISPOSE Bio AERATE ISTOCKPILEE OTHER <br /> weather or other site conditions Forward shall notify the Disposer when site ❑ SOIL- <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • REMARKS <br /> NON-Amu <br /> _ ❑ <br /> FACILITY TICKET NUMBER ASBESTbS <br /> WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE v <br /> ❑ ti <br /> ❑ ASH <br /> ❑OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARJIVAL •'`ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITI4?}iE LANDFILL THE DAY BEFORE <br /> STO SCHEDULE CALL (209) 982-4298 i+ , <br /> 01 IC557INH)6 pe GENERATOR COPY I-A MANIFEST 0 C <br /> 688976 <br />