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FORWARD NON-HAZARDOUS WASTE MANIFEST <br />' 4b <br /> IN C-0 V O R A TED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. LIS <br /> 83340 .i ' r <br /> ENERATOR ^'�-- ,T REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> �cl nmi&2 ~ r _ ®GLOVES ❑GOGGLES []RESPIRATOR ®HARD HAT <br /> MAIUNG_ADDRESS =v µ"w ` _� ~- V ❑TY-VEK [:]OTHER <br /> S21�tst Fiat Iii � _..,_. <br /> CITY,ST,TE;ZIP A 4 SPECIAL HANDLING PROCEDURES <br /> (2W)943-2011 _ <br /> SIGNATURE OF AUTHORIZED AGENT /TITLE DATE <br /> WASTEJy E _ - RECEIVING FACILITY _ <br /> vv ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • FV] 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 /> 21 S.X Nanv Drive S TOCK-roij (2 0 9) 982- 1009 FAX <br /> AME - TRACTOR LIC # TRUCK NUMBER <br /> ADDRESS TRAILER LIG # <br /> CITY,STATE,ZIP TRAILER LIC # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> El ❑ ❑ <br /> SIGIVAT,URE OF AUTHORIZED AGENT OR DRIVER DATE ROLL--OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL cuBlc YARDS <br /> Forward shall have no obligation to accept the waste,f weather or other <br /> conditions impair the safe and etfective 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 DISPOSE 810 AERATE STpCKPtLE 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 10 accept <br /> • <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> NATURE OFA THORIZED AGENT DATE <br /> r J _ ❑ ASH <br /> ❑ OTHER <br />'SCHEDULING MUST BE MADE PRIOR TO 4 OO/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) 982-4298n r <br /> Fol(c951iNH)6 96 / SALES COPY MANIFEST # C 2 0 � J 1 <br />