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FORWARD49NON-HAZARDOUS WASTE MANIFESTo ' " <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> �.0 <br /> JOB ACCEPTANCE N0. <br /> ENERATOR REOUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> peirciLnm ]GLOVES ❑GOGGLES []RESPIRATOR ®HARD HAT <br /> ' MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 2191 Nr-NNti Dant <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES <br /> 3#,rr,�.�o.s Cl4 Q 52 D5 <br /> ' PHONE <br /> CONTACT PERSON <br /> y <br /> SIGNATUP,E OF AUTHORIZED AGPNT 1 TITLE DATE <br /> ' WASTE TYPE RECEIVING FACILITY <br /> ' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ STOCKPILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 51's 1ioffC13'-I'd -=L=CA (209) 982- 1009 FAX <br /> ME rr r TRACTOR LIC 4/" TRUCK NUMBER <br /> )r __ <br /> ADDRESS l Y. <br /> TRAILER LIC <br /> CIE-"e Baz 519 <br /> CITY, STATE ZIP , TRAILER LIC # <br /> PHONE / ENPPUMP BOTTOM DUMP TRANSFER <br /> r <br /> El <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-bFF(S) FLAT-BED VAN DRUIDS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBICY,4RpS / <br /> Fon,ard shall have no obbcation to accept*,he waste if weather or other <br /> conditions impar the safe and effective disposal of the waste or ,f the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective cwatson of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept theDISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> vreather or other site cond,tions,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-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER „_, , <br /> ❑ WOOD <br /> SIGNATU E QF AUTHORIZED I GEN _ _ DATE <br /> / —� L ❑ ASH <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 /> FO iC951 TNM)6 96 GENERATOR COPY MANIFEST # 0 6 8 8 9 9 9 <br />