Laserfiche WebLink
FO� LTA��D NON-HAZARDOUS WASTE MANIFEST f <br /> V. WASTE TREATMENT' AND DISPOSAL FACILITY <br /> _ INCORPORATED , <br /> JOB ACCEPTANCE NO. <br /> ENERATO " `"^ w',.. z "•" REQUIRED PERSONAL .ROTEgUV EOUIPMENTZ <br /> BWOM rdmia m GLOVES [-]GOGGLES []RESPIRATOR ®HARD HAT <br /> IfAIL1NG DDRESS *"` tia ��,,..�t ❑TY-VEK [-]OTHER <br /> SPECIAL HANDLING PROCEDURES' (2f11,�)9d3-21)11 ....�...... ��:�...�...,,.�.�.-..� :�;.^� <br /> OONTACT PERSON' -� y � _,�_ r <br /> 7rTtdt Bor c -,�. .,_ x `r.�..�:_ s _1 ...1° 5: _�.. _:: _ f; _. <br /> SIGNATURE O AF UTHORIZI*D AGENT 1rTl _DATE, ° <br /> WAST YPE �r :��:: � tihti -. RECEiViNGwFAGIJTY� <br /> ❑ SLUDGE <br /> I ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ] DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> E] CONSTRUCTION SOIL ❑ ASH ASH <br /> 11. ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 2191 NrsyDrsve (209) 982- 1009 FAX <br /> ---ME - f _ TRACTOR LIC # TRUCK NUMBER , <br /> ADDRESS TRAILER LIC # <br /> 7-/t,�: CD <br /> • CITY,STATE, ZIP TRAILER LIC # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> u _ - ❑ ❑ ❑ <br /> SIGNATUR F AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> < ❑ ❑ ❑ ❑ <br /> y i r I Cs <br /> FORWARD INC. LANDFILLCUBIC 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 lo accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste as based on r� —yam <br /> weather or other site conditions Forward shall notify the Disposer when site O[L <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste [] SLUDGE <br /> • REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY TICKEJ,NUMBER ASBESTOS <br /> i ❑ WOOD <br /> NATURE,IOF AUTHO ZED XAGET DAT <br /> c j� ❑ ASH <br /> OTHER <br />�LJ ING MUST BE MADE WOR TQ j,21 :E THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> 'f TO REFUSAL UPON ARRIVAL Of�GOT�TCYDELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> 70 SCHEDULE CALL (209)982-4298 <br /> FO (c951>NHy6 ss MANIFEST # C <br /> SALES COPY _ _ _ 715005 <br />