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FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> I N C O R-PO R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. !Q0:3 <br /> ENERATOR "}:' .a_i � ' _ .:,.._..dam <br /> r r '� _ r-- REQUIRED PERSONAL PAOTECT1Vl<EQUIPME - , <br /> MCI gtaidea Fellro 1=11 _ M GLOVES [D-GO-GG-LES ❑RESPIRATOR ®HARD HAT <br />' MAiL1NG ADDRESS CRs - `', T L " ❑TY VEK []OTHER <br /> --k <br /> STATE; JEP '-V = - "Y SPECIAL HANDLING PROCEDURES <br /> (209)943-2011 <br /> CONTACT PERS01V <br /> Nick Ban" <br /> S_IGNATUAE OF A—U_THORIZED AGENT/ TITLE DATE <br /> / <br /> • WASTE EYP Y - _ RECEIVING FACILITY v <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS 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 /> 'z91 CKMN (209} 982- 1009 FAX <br /> NAME TRACTOR LIC TRUCK NUMBER <br /> ADDRESS TRAILER LIC #l J_T) <br /> t; <br /> 1 <br /> CITY,STATE,ZIP nn TRAILE14 LIG # _ <br /> s�y !1 �`T �' �✓ Ste - l� ]1 C..1 7 r <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OFeA�ITORIZ�D AGENT OR DRIVER DATE ROLL❑OFF(S) FLAT-BED VAN DRUMS <br /> /Idf ❑ ❑ ❑ ❑ <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 inabildy to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on Q�OIL <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 DATE <br /> i ❑ ASH <br /> O ' <br /> 7k � <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 <br /> F01(C9511NH)6 96 SALES COPY MANIFEST # C 7 <br /> r.�0 2—%5 <br />