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PUKWARDNON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED <br /> a WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. F,j <br /> . <br /> GENE- .( RE IRED PERSONAL PROTECTIVE EQUIPMENT <br /> TIP � �/f � l GLOVES ❑GOGGLES ❑RESPIRATOR iARD HAT <br /> TAILING A�DRESS - ~��`" r ^� ❑TY-VEK ❑OTHER <br /> G 1 r � <br /> CITY, S�E, SPECIAL HANDLING PROCEDURES � <br /> G �'�_ __ <br /> PHONE " <br /> CONTACT PERSON <br /> Ive <br /> ERS N_ <br /> �ic <br /> SIGNATURE 6F AUTHORIZED AENT/ DAT <br /> WASTE TYPE RECEIVING FACIUTY <br /> SLUDGE <br /> ❑,TREATMENT SOIL <br /> ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> Ej DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> IAE L_ 17t� L' ku C Kf'n NOTES TRUCK NUMBER <br /> ADDRESS <br /> . CITY,STATE,ZIP <br /> 1 097 <br /> PHONE END PUMP BOTTOM DUMP TRANSFER <br /> Q0 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> El El <br /> t <br /> FORWARD INC, LANDFILL CUBIC YA <br /> Forward shall have no obligation to accept the v aste,f weather or other 1 <br /> conditions impair 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 shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE f310_ AERATE 5TOCtCPILf OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions,Forward shall not,'y the Disposer when site Z SOIL <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste _ _ _ ❑ SLUDGE <br /> ` REMARKS <br /> 14ON-FRIABLE <br /> 4� ❑ ASBESTOS <br /> FACILITY''nCKET NUMBER' <br /> ..s WOOD <br /> SIGNATURE O,E; JTHORIZED�A, T a DAA <br /> ❑ <br /> 1- I � <br /> ASH <br /> OTHER <br /> CHEDULING 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. i <br /> r SCHEDULE CALL(209) 982-4298 57969 <br /> MANIFEST * { <br /> GENERATOR COPY <br />