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Y <br /> WARD <br /> NON=HAZARDOUS WASTE MANIFEST <br /> R WASTE TREATMENT AND DISPOSAL FACILITY <br /> _ - , <br /> _•� JOB ACCEPTANCE NO• <br /> GENERATOR`S rx rr - -"6.t— a _ o.•,S w <br /> r1:ti ���� -�-T = 3„ �-�� REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> r ;l�, _ �r # _W ,�_ [I GLOVES -[:]GOGGLES ❑RESPIRATOR ❑H� RD HAT <br /> r - MAILING ADDRESS 4,i -, -' ,'mea,_ ❑TY-VEK ❑OTHER <br /> LG � !U <br /> CITY,STh�E,7JP- v SPECIAL HANDLING PROCEDURES <br /> =-- - - _ ---- - -- _ -- = __ _ <br /> PHONE <br /> CONTT PERSON /) <br /> SIGNATURE dF AUTHORIZED AGENT/TITLE DATE <br /> Yi �• orf- I <br /> E TYPE:+• RECEIVING FACILITY - r <br /> + • + •rrr ❑ SLUDGE <br /> TREATM&;T SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DISP0GONS FftJC- L ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> GONSTI�kJCT10N SOIL E] ASH <br /> + + .+.•.+ ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERAnNGfACIUTY (209) 982-4298 PHONE <br /> •. I <br /> I- (209) 982- 1009 FAX <br /> NAME [ �. � �� h Ec l-7 A Tl C ►'� NOTES -- TRUCK NUMBERt- <br /> ADDRESS ` 1 G - k 4 I G k f-1 4 Lt <br /> • CITY,STATE, ZIP G1 r r{Sc / C <br /> f� <br /> PHONE "I a �-r'' / cy t�' END DUMP BOTTOM DUMP - TRANSFER^ <br /> ❑ ❑ _ ❑ ___ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT BED VAN DRUMS <br /> �C frit <br /> zz El <br />` FORWARD INC. LANDFILL CUBIC 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 Y - s,T„-,•. <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE ; $10`� AERATE SiOC#�ilE •OTHt <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions.Forward shall notify the Disposer when site ❑ SOIL <br /> • conditions are expected to change such that Forward tAnll be able to accept <br /> the waste ❑ SLUDGE <br /> -__ <br /> • <br /> NON-FRIABLE <br /> FACILITY Tl NIdfER �`�'° " ❑ ASBESTOS <br /> f =moi ❑ WOOD <br /> SiGTUR�OI`AUTHORIZED ALIT DATE <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)982-4298 SALES COPY MANIFEST # 35573 <br />