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v NQNE�ARDOU Nppsos MANIFEST T �AACUTY <br /> JOB ACCEPTANCE NO. _ <br /> RE <br /> �, _ __ <br /> Ilq-�G D ; cr- - GLOVES []GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> t. eK,, ,mss <br /> ❑TY-VEK ❑OTHER <br /> SPECIAL HANDLING PROCEDURES <br /> PHONt <br />' NFAC3;�ERSOIJ � �� <br /> , K' RECEIVING FACILITY:" <br /> SLUDGE <br /> ❑ TREATMENT SOIL ❑ <br /> `DISPOSAL SOIL 0 NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ WOOD <br /> �] CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> r ❑ OTHER <br />' <br /> wrY MANTECA, CALIFORNIA 95336 <br /> �Erv�RAnnIG FAc <br /> - (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME z t <br /> --.- _ NOTES_ ._ _ Ww <br /> I ,! z f( � - TRUCK NUMBER <br /> ADDRESS <br /> • CITY,SfATE� ZIP V f w <br /> PHONE <br /> END DUMP BOTTOM DUMPTRANSFER <br /> _ SIGNATURE•OF AUTHORIZED AGENT OR DRIVER DATE 111:1 _ <br /> ROLL-OFF_(S) FLAT-BED VAN DRUMS El 0 <br /> FORWARD INC. LANDFILL CUBI§ YARDS <br /> Forward shall have no obl,gat,on to accept the waste of weather or other <br /> conditions impair the safe and effective disposal of the waste or if the waste <br /> impairs the Safe and effective operation of the Landfill Forward shall use DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) } <br /> reasonable efforts 10 promptly notify Disposer of its inabilityto accept the <br /> waste for any reason If Forwards refusal to accept the waste is based on I--I _ - .. DJSPOSE BIO AERATE STOCKPILE OTHER <br /> weather or other site conditions Forward shalt notify the Disposer when solei SOIL <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste <br /> REMARKS - W`w w _ _ _ ❑ SLUDGE <br /> ❑ NON-FRIABLE <br /> L�71'T!CltE'f 7VUMBER M_x w _ - ASBESTOS <br /> SlGtiIgTURE - _ _ ❑ WOOD <br /> OF AUTHORIZED AGENT 4 _ ._._ DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> CHEDULlNG 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 BESCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> SCHEDULE CALL (209) 982-4298 <br /> MANIFEST # 57831 <br /> SALES COPY <br />