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Yvt�-s,�cRrcuuvZ) VvAbT� MANIFEST <br /> vr� ! N C O R P O R A TED �'"`�" WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. -74571 j=' <br /> GENERATOR <br /> hS..p p� REOUIRED PERSONAL PROTEGTIVl=EQUIPMENT <br /> MAILING ADDRESS ©GLOVES ❑GOGGLES ❑RESPIRATOR ©HARD HAT <br /> 2191 Nk"1`�rrvc ❑TY-VEK [3OTHER <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES <br /> • S'�CiacaCA 95200 <br /> PHONE <br /> ' CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED GENT/,71TLE DATE' <br /> ! ' <br /> WASTE TYPE <br /> RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE AS—EESTOS FORWARD INC LANDFILL <br /> • El DISPOSAL SOIL ❑ WOOD <br /> ' ❑ CONSTRUCTION SOIL ❑ ASI-1 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> ' GENERATING FAC1LiTY <br /> 4=„�,o: (209) 982-4298 PHONE <br /> j^«�Find 7%��'v?i=CA <br /> (209) 982- 1009 FAX <br /> ' NAME <br /> Ls -tit Trot-„^�� TRACTOR LIC f�7, � TRUCK NUMBER <br /> DDRESS TRAILER LIC f/G .7 <br /> • CITY,STATE, ZIP TRAILER LIC <br /> PHONE <br /> 51- END BUMP BOTTOM DUTAP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVE DATE ROLL-OFFS ❑ ❑ <br /> ( ? FLAT-BED VAN DRUMS <br /> El <br /> ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS I <br /> Forward shall have no obhuolzon to acce;, `�e waste if weather or ether <br /> condd ors impair the safe and eNcctive d*pesal of the waste or if tie waste <br /> Impar s the safe and effective operation of `e Landfill Forward small use DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> reasonable efforts fo promp+ly notify Disposer of its inab ity 10 accept the DISPOSE 810 AERATE STOCKRLE <br /> waste for any reason if Forwards refusal to accept the waste is based on OTHER <br /> weather or other site condi pans, Forward shall,:'rfy the Disposer when site El SOIL <br /> ' <br /> condi*ns are expected to change such that Fo-ward will be able to accep� <br /> the waste <br /> REMARKS ❑ SLUDGE <br /> ❑ NON-FRIABLE <br /> FACILITY TfCKE[14UMBER ASBESTOS <br /> SIGNATURE OF�JTHORIZED AGEDATE <br /> NT ❑ WOOD <br /> ^ <br /> ❑ ASH <br /> ❑ OTHER <br /> C ULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • <br /> BJECT 70 REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WI ANY UNSCHEDULED LOADS ARE <br /> SCHEDULE CALL (209)982-4298 TH THE LANDFILL THE DAY BEFORE <br /> FO1fC85HED P6 <br /> GENERATOR COPY MANIFEST # C <br /> 688980 <br />