Laserfiche WebLink
f NON-HAZARDOUS WASTE MANIFEST <br /> FORWARD <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> INCORPORATED <br /> JOB ACCEPTANCE NO. <br /> -A= r: � :,r ', .:r'' REQUIREi) N,4 <br /> PERSOPROTEC_FiVE EOUIPMfrN'f: �. r -v <br /> ENER'TRR2=0 " ``""W"" ®GLOVES []GOGGLES ❑RESPIRATOR ©HARD HAT <br /> Mr1 Har»dCs Fa - ,-p -m- ❑TY-VEK [:]OTHER <br /> w i wM- '. <br /> 32 _ _ } SPECIAL HANDLI <br /> S�tNG PROCEDURES <br /> CE7 ATE Za <br /> dt,OA95245 <br />' CANTAGTPERSONT -�'_ <br /> Nick Barsrl _ _ <br /> SIG NA REAUS ZED AGENT%TITLE ' Y DATE <br /> • - y`< - . <br /> RECEIVING FACILITY - <br /> WASTE TYPE—, _ - <br /> ❑ SLUDGE FORWARD INC LANDFILL <br /> ❑ TREATMENT SOL ❑ NON-FRIABLE ASBESTOS <br /> • R] DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY <br /> (209) 982-4298 PHONE <br /> ;h;.yam SITOCKIMIN (209) 982- 1009 FAX <br />' TRACTOR LIC # TRUCK NUMBER <br /> NAME �, ` <br /> r 1 LJ � TRAILER LIG L, ', <br /> ADDRESS <br /> . CITY,STATE,ZIP TRAILER LIG # <br /> ' END DUMP BOTTOM DUMP TRANSFER <br /> PHONE ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ,i ROLL-OFF(S) FLAT-BED VA❑N DRUMS <br /> - CUBIC YARDS <br />' FORWARD INC. LANDFILL ,,- <br /> Forward shall have no obllgatlon to accept the waste rf weather or other <br /> conditions impair the safe and effective disposal of She 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 BIO AERATE STOCKPILE OTHER <br /> reasonable efforts 1c, promptly notify Disposer of is inability to accept the <br /> waste far any reason If Forwards refusal to accept the waste is based one SOIL <br />' weather or other site condition Forward shall notify the Disposer when site <br /> conditions are expected to change such that Forward will be able to accept SLUDGE <br /> the waste <br /> REMARKSNON-FRIABLE <br />' ❑ ASBESTOS <br /> FACILITY TIC�C-ET NUMBER ❑ WOOD <br /> SIGNATI4E OF A� ORIZEDrAGENT/ �E3 ,� ❑ <br />' ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY TO EXCTED AANY <br /> LOADS ARE <br />' SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIIES MUST BE SCHEDUL EID VAL WITH THE LANDF LDL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 MANIFEST # C <br /> ALES OPY l0 5 <br /> S <br />