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E <br /> NON-HAZARDOUS WASTE MANIFEST <br /> FORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INCORPORATED ' <br /> JCB ACCEPTANCE NO. f <br /> PERSONAL'POT�L71Vi`EOU[PMENT ;,_;; ; <br /> Md�da Fcftr= GLOVES [I GOGGLES [:]RESPIRATOR ®HARD HAT <br /> UIWLW, G�DDRESS a.�y :� � Y 'i.R-ta ❑TY-VEK ❑OTHER <br /> S21 Wr>�t Psae <br /> + SPECIAL HANDLING PROCEDURES <br /> lIl j ST <br /> • �.yrs-..�y <br /> (20)943-1611 <br /> ��[[�� 9+ A/*►* <br /> "17 <br /> CONTACT PERSON. f x ..sfa i-: � 5 ��vd � .r•.ti.vL�F �w�t <br /> SIGNATI]Rl=UF_AUTHORlZE0 AGENT, <br /> WASTE TYP!i�-'' _ - RECEIVING FACILITYr <br /> ❑ SLUDGE FORWARD INC. LANDFILL <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS <br /> • ] DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> • GENERATINGFACILITY (209) 982-4298 PHONE <br /> 2191NwyDl1 e sTOc To (209) 982- 1009 FAX <br /> NAME A- _ }[ TRACTOR LIC # TRUCK NUMBER <br /> 5f3<�.? 5�17 <br /> ADDRESS ;k-1 I TRAILER LIC # <br /> '< �'</'< <br /> • CITY,STATE,ZIP TRAILER LIC # <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ <br /> SIGNATURE O(A 1THORIZED AGENT OR DRIVER DATE ROLL-&F(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other rf^ <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 B!O 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 /> I weather or other site conditions, Forward shall notify the Disposer when site <br /> ' <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> F NON FRIABLE <br /> ❑ ASBESTOS <br /> ACILITY TIC)<6 NUMBEF� <br /> ♦ • ❑ WOOD <br /> SIGNATU OF�U IZETI AGDATE <br /> - I, ) ASH <br /> IL �� ❑ OTHER <br /> Ir > <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 BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209)982-4298 �, MANIFEST # C ? ''L-ta 0 r <br />