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r <br /> FORWARD '- NON-HAZARDOUS WASTE MANIFEST <br /> 'b <br /> INCORPORATED e WASTE TREATMENT AND DISPOSAL FACILITY <br /> ,�. JOB ACCEPTANCE NO. 3300'y <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT; <br /> el Dwidsa Pdnkun '"" _ _ _ _ _ gj GLOVES [:]_GOGGLES[]RESPIRATOR ®HARD HAT <br /> MA1L11GADDRESS; -_ _ ,_ 3 r� �_ ,` -,� ❑TY-VEK ❑OTHER <br /> X31 West pme sh*d <br /> Tq7+> STA'fE, SPECIAL HANDLING PROCEDURES <br /> Tib§j i,92011 <br /> CONTACT <br /> �t11*Bonda Y 6 •. <br /> SIGNAT1JRE OF AUTHORIZED AGENT 1 TITLE _ DATE <br /> WASTE TYPE RECEIVING FACILITY , <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • JE] DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STC K PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 21.01 Nsl-y D*"{ STOCKTON (209) 982- 1009 FAX <br /> AME J /e C AJ C_ TRACTOR LIC # _ TRUCK NUMBER <br /> p j <br /> ADDRESS Z7/U LG0A,i 3 I� I� 1 TRAILER LIC C <br /> CITY,STATE,ZIP 7 TRAILER LIC # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> a_ 11 1:1SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other r fir, <br /> conditions impair the safe and effective disposal of the waste or it 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 STOCKPILE 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 <br /> weather or other sste conditions, Forward shall notify the Disposer when site 601L <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 /> GNATIE OF�AUOR1ZEFf AGENTDATE <br /> t 1! ❑ ASH <br /> L <br /> ( } ,'r I ��+ fr'� ; ❑ 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 13E SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL 0209) 982-4298 <br /> Fol(C951iNH}6 96 SALES COPY MANIFEST # C 7 /n <br /> � r3 /1 0 <br />