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i .4 - FORWARD NON-HAZARDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. $53301 <br /> ENERATORa',=1 w y y „^: REQUIRED PERSONAL PROTECTIVE EQUIPMENT-, <br /> d B 'des P _ _ -Y EI GLOVES ❑GOGGLE_S [:]RESPIRATOR ®HARD HAT <br />' MAILING DADA DRESS` ��~ - `, �« _z '�r F`�" ❑ <br /> �� ,� TY-VE ❑OTHER <br /> Wei Fme �"' <br /> FAaTIyt;YP �='` "' - SPECIAL HANDLING PROCEDURES <br /> • ALA.<+JS 93245�...a L`L=ic., - <br />' • PHONE�. �.:h q� .� - _�., ..,, .l.._ ' _ ". 4_ _� � _ <br /> CONTACT PERSON <br /> I <br /> Mc k Bass <br /> SIGNATURE OF AIiTHORiZEO AGENT /T1TLE DATE <br />' WASTE TYPE,, F <br /> RECEIVING FACILITY f �, <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • r� 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 /> L141NEvyDrive STOC'sTON (209) 982- 1009 FAX <br /> ME TRACTOR LIC # TRUCK NUMBER <br /> 1 `�=� <br /> ADDRESS _ TRAILE4iCIC k w <br /> CITY, STATE, ZIP v y✓ 1 C ![!J TRAILER L C # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL!OFF(S) FLAT-BED VAN DRUMS <br /> r ❑ ❑ ❑ ❑ <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 y DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forward s refusal to accept the waste is based on �x� <br /> weather or other site conditions Forward shall notify the Disposer when site u SOIL <br /> ' conditions are expected to change such that Forward will be able to accept'the waste ❑ SLUDGE <br /> REMARKS <br /> ' BION-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> i <br /> ❑ WOOD <br /> -' <br /> GNATURE OR AUT D�D GENT , <br /> r <br /> .. � , !!! L ❑ ASH <br /> ❑ OTHER <br /> MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />,SCHEDULING <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 /> FOI IC961INH)6 96 SALES COPY MANIFEST # C 72024'14 <br /> 72024'1 <br />