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ORWA <br /> RD o, NON-HAZARDOUS WASTE MANIFEST <br /> C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. 745711'; <br /> LENERATOR _ REQUIRED PERSONAL PROTECTIVE EOUIPMENT <br /> �F Frirala:m ©GLOVES ❑GOGGLES [-]RESPIRATOR ©HARD HAT <br />' MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 2151 Na,N Envie <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> :Xd=rsC495206 <br /> - PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DAT <br /> .. *�i i':✓��tai ,' / ice,_-� <br />' WASTE TYPE RECEIVING FACILJTY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • fl DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br />' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br />' s`s=.:CtDr-'Er«; V, ",.�TEICA (209) 982- 1009 FAX <br />' ME TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS TRAILER LIC / f � <br /> - CITY,STATE, ZIP TRAILER LIC <br /> 33'v7rro.0 A 934141 <br /> PHONE END DU BOTTOM DUMP TRANSFER <br /> k9i5)14 n <br /> 33- <br /> SIGNATURE OF AUIKORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> F ..;� ��-7rl ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuB:cjIARDq <br /> Forward shall have no oblicatlon to accept the waste of weather or other <br /> cond4ions impair the safe and etfective disposal of the waste or d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the sale and effective operation of the Landfill Forward sharl use <br /> reasonable efiorts to promptly notify Disposer of its inability to accept theDISPOSE BIO AERATE STOCKRLF OTHER <br /> Haste for any reason If Forward s refusal to accept the waste is based on SOIL- <br /> weather or other srte 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 /> REMARKS <br /> NON-FRIABLE <br /> _ ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> Ir I E] WOOD <br /> SIGNATURE OF 4HOf ED AGENT DATE - <br /> ,7 ❑ ASH <br /> ` ❑ <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />,SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 <br /> F014CS511NHMANIFESTO C6)6 96 •� GENERATOR COPY $ 8 2 <br />