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, FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. 883300`, 14 . r <br /> ENERATOR IE2Y REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Md HaFi�d� ®GLOVES ❑GOGGLES [:]RESPIRATOR ®HARD HAT <br /> TJIAtLING ADDR, S$, +`, u ' ... �s� -V _ :_ _ u . ❑TY-VEK ❑OTHER <br /> 521 Weat Prue Sued SPECIAL HANDLING PROCEDURES <br /> iTY <br /> ' (2053 943-x(111 <br /> _PHO <br /> CONTACT PERSON'-- - <br /> N-h*BceAm <br /> SIGNATURE OF AUTHORIZED AGENT TITLE_ DAT <br /> WASTE TY t* 'y - r RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • El 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 /> 2 2 <br /> IS)INsvvD STC-CLITOrl (209) 982- 1009 FAX <br /> NAME f } TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS N 6 w ��J�1 I �� i �C\�\ c( 3 36 f� <br /> TRAILER LIC # <br /> 113 U u .A 42 <br /> • CITY,STATE, ZIP TRAILER LIC # _ <br /> G S 1 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 0 ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> Ej <br /> 7�C ,( cwt-�-�-� 1< �.. j i J-►�-r-t G <br /> FORWARD INC. LANDFILL CUBIC 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 <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <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 <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> IGNATURE OF AUTHORIZED AGENT <br /> ASH <br /> /DATE <br /> '`- ❑ OTHER <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 5 <br /> FO (C9511NH)6 96 SALES COPY <br />