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RWAR�� NON-HAZARDOUS WASTE MANIFESTFo <br /> -•-f N C 4 R P O+ A D WASTE TREATMENT AND DISPOSAL FACILITY <br /> AS ACCEPTANCE NO. ',9040 <br /> E ERATO j °• ''ti -fREQUIRED P� SON <br /> RAL.PAOTECTIVE EOUIPMENT_ "r <br /> 1191 Bodda GLOVES [:]GOGGLES �RESPIRATOR ®HARD HAT <br />' MAILING ADDRESS „ ,_ __ _ ❑TY VEK []OTHER <br /> 211�/West�y� SPECIAL HANDLING PROCEDURES <br /> 'QI1 Iy-S-STATE.LIP <br /> - -PHONE ` <br /> (209)943-2011 <br />' oCONTACERSON <br /> Ni k - --- - <br /> SIGNA U AUORI D AGE / TITLE DAT <br /> - - _ <br /> 14 17� <br /> W E_TYPE _ _ � � —___._ RECEIVING FACILITY <br />' ❑ SLUDGE <br /> ❑ TREATMENT SOIL F1NON-FRIABLEASBESTOS FORWARD INC. LANDFILL <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 />' 444M0&UJWIP_Road LA' P (209) 982- 1009 FAX 1W <br /> NAME �'-� - i"U► 1 g_ _ TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS {��j - O 64 _ _ _ TRAILER LIC #/�,JLJ <br /> ' . CITY,STATE,21 {{�si_�i (,c� TRAILEE� LIC # <br /> 7 <br /> PHONE__ _ EN UMP BOTTOM DUMP TRANSFER <br /> PHONE - _/ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> El El El El <br /> FORWARD INC. LANDFILL cuPlc YARDS <br /> Forward shall have no obligation to accept the waste if weather or other <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 -r pIShOSE 810 AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the <br /> waste for any reason If 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 NON-FRIABLE <br /> _ __ ❑ ASBESTOS <br /> FACILl7Y TICKET NUMBER <br /> ❑ WOOD <br /> IGNATURE OF AUTHORIZED AGENT - DATE . f <br /> ❑ ASH <br /> '� fdi' •��'� � f� ':/%' ❑ OTHER <br /> ,r <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 /` MANIFEST # C <br /> F01(C9511 NH)6-96 SALES COPY 72021 <br />