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(#�TORWARD <br /> INCORPORATED NON-HAZARDOUS WASTE MANIFEST { <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> � � � � <br /> r JOB ACCEPTANCE N0. <br /> ENE¢iATOR" REOl�1RED PERSONAL PROTECTIVE EQUpg JT <br /> .sti. _ <br /> Mel Buida pe.olv= X]GLOVES ❑GOGGLES [:]RESPIRATOR ®HARD HAT <br /> MAILING ADD ES {a, �77r. ,�-°s'� - ' ElTY-VEK ❑OTHER <br /> ���� <br /> 521 Wed Pme ftieet <br /> CIT16STA ZlP - SPECIAL HANDLING PROCEDURES <br /> • k�C,A 3245 <br /> PHON ` ' F x s <br /> [ 9)943-2011 -- <br /> CONTAC�'PERSON <br /> C3c Bor:�a _ <br /> SIG URE�OF AU H-]ORIZED AGI=NTShT1TLEA DATE~ y _ <br /> WASTE LYPE�`, � �� ' _ r:"� _ ' `, RECEIVING FACILITY <br /> I ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ] DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ' ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 3 f91 Navy Dme S 1'OCKMN (2 0 9) 982- 1009 FAX <br /> I <br /> ME �1 9 TRACTOR LIC #Z-ID 75_u-Z� TRUCK NUMBER <br /> NA �i 1 -T/�� w��.-rc.�� <br /> ADDRESSCry 7j 1 -�r7.�tJ t c C��� TRAILER LIC # I L4 r {J i' ✓ <br /> CITY,STATE,ZIPJ?u b4, c,ie- `ck `/ 3 TRAILER LIC # <br /> • <br /> PHONE , . r --� END DUMP BOTTOM DUMP TRANSFER <br /> r-.r �C� 7 ..�-�-r�,o <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF ❑S) FLAT-BEDVAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other <br /> I 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 DISPQSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on /SOIL <br /> I weather or other site conditions Forward shall notify the Disposer when site LJ <br /> conditions are expected to change such that Forward will be able to accep <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> t ❑ ASBESTOS <br /> FACILITY�CICET NUMBER-- ❑ WOOD <br /> IGN/jT{JPE OF AU ORIZED AGENT 7�4 <br /> ❑ <br /> - -, ASH <br /> ❑ 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 BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (209) 982-42987 ��Q ({7 <br /> i aces,znrrws 96 CGr ;:_qcnpv - MANIFEST # C <br />