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FORWARDNON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED � WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. 1-74571f:, - -" <br /> ENERATOR REQUIRED PERSONAL PROTECTIVE EOUIPMENT <br /> P pefsv;cm Q GLOVES []GOGGLES ❑RESPIRATOR s❑HARD HAT <br /> MAILING ADDRESS [:]TY-VEK []OTHER <br /> 2191 Nt vy Drive <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> Swddon C,A 95245 <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> C] TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • p DISPOSAL SOIL ❑ WOoD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ <br /> STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 9-AE :311141�*r=�fi� (209) 982- 1009 FAX <br /> MEtt �J7�� '/1 7 2 T TRACTOR LIC #����2�^ r TRUCK NUMBER <br /> // / -l+�f�' I` F..�A C Mfr T"l�+� , ���^ I� � �+ <br /> ADDRESS TRAILER LIC #/ (9, �--} <br /> best cpffize S^C f 19 <br /> • CITY, STATE,ZIP f TRAILER LIC # <br /> B%-'.�CA 934 i4 f j/. /rt 7L,,n <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> El <br /> SIGNATURE OFA THORIZED AGENT OR DRIVER DATE ROLL OFFS) FLAT-BED VAN DRUMS <br /> ' CUSIC�YARD15' <br /> FORWARD INC. LANDFILL 1 V <br /> Forward shall have no oblrcauon to accept the waste it weather or other I % <br /> COndM011S impair the safe and efiectrve disposal of the waste or d the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and eifecine operation of the Landfill Forward shdil use <br /> reasonable efforts to promptly notify Disposer of its rnabildy to accept the / DISPOSE Bip 1 AERATE STOCKPILE OTHER <br /> waste for any reason If Forward s refusal to accept the waste is based on �501L <br /> weather or other site coneittons Forward shall notify the Disposer when site ' <br /> conditions are expected to change such that Forvxard will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> - ❑ NON-FRIABLE <br /> _ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> � - - - � - - - ❑ WOOD <br /> SIGNATURE OF AUTHORIZED(GE y DATE _ <br /> E] ASH <br /> t <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> UBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> IF, <br /> SCHEDULE CALL (209)982-4298 <br /> ice5$1NHJ s PMANIFEST # Cs GENERATOR COPY 688983 <br />