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0+0 FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> .� ° " _ 're SAL FACILITY <br /> 4� INCORPORATED WASTE TREATMENT AND DISPO <br /> `� JOB ACCEPTANCE N0. 74711=�= K� - � - �� <br /> NER4TOR REOUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> perole= ®GLOVES [:]GOGGLES ❑RESPIRATOR ©HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 2191 1tar*� D7ve <br /> SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZIP <br /> � St�:�C49s2DS <br /> PHONE ' V <br /> l <br /> CONTACT PERSON <br /> SIGN,TURE OF AUTHORIZED AGENT / TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE FORWARD INC LANDFILL <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br /> • © 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 /> 9;Sr105e_:r.,3 (209) 982- 1009 FAX <br /> ME ' y TRACTOR LIC #� �{Zr, / TRUCK NUMBER <br /> � % �� 3� <br /> ADDRESS TRAILER LIC #/ I <br /> - CITY, STATE,ZIP TRAILER LIC # <br /> PIN <br /> PHONE ENDpUMP BOTTOM DUMP TRANSFER <br /> Ss El <br /> SIGNATURE OF AUTHeAIZED AGENT 09 DRIVER DATE ROLL-OFFS) FLAT-SED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS r - <br /> Forward shall have no oblsgatpon to accept ,tie waste of weather or other �-- <br /> cond tions irrmpair the safe and effective 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 shill use ' DISPOSE B10 AERATE S70OKPILE OTHER <br /> reasonabie efforts to promptly notify Disposer of its inabiiity to accept the <br /> waste for any reason It Forwards refusal to accept the waste is based on SOIL <br /> weather or other site 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 /> WOOD <br /> SIGNATURE <br /> SIGNATURE OF AUTHZED EN r DATE <br /> ASH <br /> OTHER❑ 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 REFOSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO <br /> sSCHEDULE CALL(209)982-4298 MANIFEST # C <br /> GENERATOR COPY 688986 <br />