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j0;24q-_'_F0RWARD NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. $,' rad4 ; <br />' _ENERATOR - REQUIRED_PERSONAL PROTECTIVE EQUIPMENT _ <br /> .Id Bmisk_s Pdro;mw - 1 ®GLOVES ❑GOGGLES [:]RESPIRATOR ®HARD HAT <br />' MAILItVG ADDRESS~s�; .0 - 4 W - __ ❑TY-VEK ❑OTHER <br /> 823 Weslt Pie E�eir ;: �, <br /> Sil' STt Pme SPECIAL HANDLING PROCEDURES <br /> . Iio,CA93245 <br /> _CONTACT PERSON - - <br /> Nick H� v _ <br /> SIGNATURE OF AUTHORIZED AGENT/-TITLE DATE <br /> 7k <br /> WASTE TYPE - RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • � DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> " ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 219Ie STCYCK O-IN (209) 982- 1009 FAX <br /> ME G�Sa, TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS TRAILER LIC # <br /> JCr <br /> CITY, STATE,ZIP Cj ZC(G�-��1 �,�} �S TRAILER LIC # f <br /> • PHONE_ 4,{, I�j END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OFA L4 HORIZED AGENT OR DRIVER DATE ROL -OFF(S) FLAT-BED VAN DRUMS <br /> El EJ E3 <br /> FORWARD INC. LANDFILL CUBIC YARD§y,,, <br /> Forward shall have no obligation to accept the waste if weether or other <br /> conditions impar 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 Landfall Forward shall use DISPOSE BIO AERATE ISTOCKPIi-E 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 ��''1J <br /> weather or other site conddsons Forward shall notify the Disposer when site 0 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 T1CF�ET NUMB R <br /> / � _ ❑ WOOD <br /> 'JNATU E OF #J O ZED p6ENT; f DA;' ❑ ASH <br /> I <br /> 1 ❑ OTHER <br /> CHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> USJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> O SCHEDULE CALL (209) 982-429$ <br /> F01(C951 INH)6 96 SALES COPY MANIFEST # C 720259 <br />