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{ ' .r ■ "*yes ' NON—HAZARDOUS WASTE MANIFEST <br /> ;y� s jarla� xr'1 <br /> � ��.�, �'", * f WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB AOCEPRTANCE NO. -- <br /> = <br /> GENERATO `� Y= z _�E- <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT i-: <br /> xRIFTY70l �� x ❑GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING AIft " ' �"-t s_}iDa i _]TY-VEK ❑OTHER <br /> .I g�, '`"''' "0— SPECIAL HANDLING PROCEDURES <br /> CITY,STATED!R ' <br /> r <br /> PHONE''- 7 <br /> - RJAYMOk FRIEDRICHEEN <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> ,. <br /> WASTE TYJO *r RECEIVING FACILITY <br /> I * # s ❑ SLUDGE <br /> TREATM6IT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> + 'tISPO�jcV6IL ElWOOD <br /> tONST[ CTPN SOIL ElASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> G VRATVP^IM OIL COMPANY - (209) 982-4298 PHONE <br /> A 14fr <br /> ,*,17 PACIFIw AV NUE (209) 982- 1009 FAX <br /> NAMENOTES TRUCK NUMBER <br /> P*1SFSTT mRaSI9?^._PT T1 VONT � C . �. <br /> ADDRESS <br /> 920 S11IL1011i RD #44 -7 <br /> . CITY, STAT Ii�fmsop" C cls ,192 <br /> • PHONE 747-63e—x407 END DUMP BOTTOM DUMP TRANSFER - <br /> ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR IVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> fl 1 �25-�,' d �� ❑ El 13 ❑ <br /> 7� 11 f <br /> FORWARD INC. LANDFILL CUBIC YARDS - <br /> Forward shall have no obligation to accept the wasted 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 shat] use <br /> reasonable efforts to promptly notify Disposer of its Inability to accept the DISPOSE BIQ AERATE ST06(I'l E OTHER.,` <br /> waste for any reason If Forwards refusal to accept the waste is based on SOIL - _ Y <br /> weather or other site conditions Forward shall ratify the Disposer when site <br />' conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> • REMARKS - <br /> ■ NON-FRIABLE <br /> ❑ ASBESTOS <br />' FACILITY TICKET NUMBER _- _ _ <br /> ❑ WOOD <br /> SIGWMJf tE OF AUTHORIZE-D DATE - ❑ ASH <br /> 7�' _ �?��.• � <br /> 'nOTHER <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 GENERATOR COPY 9271 <br /> MANIFEST # C <br />