Laserfiche WebLink
NON-HAZARDOUS WASTE MANIFEST <br /> -F6RWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> AIC JOB ACCEPTANCE N0. <br /> GENERATOR _ REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br />' _UlT +"�' T�, y`�!�Gia�u Y ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD !-IAT <br /> MAILING ADtt12100 LAKEMOO BLVD _ CITY-VEK [-]OTHER <br /> SPECIAL HANDLING PROCEDURES <br /> CITY,STATeYJP t` ;A <br /> PHONE <br /> 1 ■ <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> • WASTE T RECEIVING FACILITY _ <br /> cCA C ❑ SLUDGE <br /> JREATM NT�SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPO*OIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br />' 'CONSTBHCT�N SOIL E] ASH <br /> C G" ''c.. ❑ OTHER MANTECA, CALIFORNIA 95336 <br />' �,IERAT OTS �_.- _;__9:Uri - - --- - -----{209} 982-4298 PHONE <br /> Cr ~ - - - '• --- <br /> -- (209) 982- 1009 FAX <br /> NAME -_;,�i N 1*�+ �� , K�+ Jj,,c ,i� a i N NOTES TRUCK NUMBER <br />' ADDRESS - <br /> • CITY, STAT&.^ <br /> • PHONE "� "3- =' r END DUMP BOTTOM DUMP TRANSFER <br /> .. ❑ ❑ ❑ <br />' SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS _ <br /> r � / ❑ ❑ ❑ ❑ <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 DISPOSE BIAERATE r flTIt1E <br /> reasonable efforts to promptly notify Disposer of its inabil,ty to accept the — <br /> waste for any reason If Forwards refusal to accept the waste is based on ❑ SOIL <br /> weather or other site conditions, Forward shall notify the Disposer when site <br />' conditions are expected to change such that Forward will be able to accept <br /> ❑ SLUDGE <br /> the waste <br /> • REMARKS _ - - - NON-FRIABLE <br /> ❑ ASBESTOS <br />' FACILITY TICKET NUMBER -- _" _ ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT 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 LLC E DAY BEFORE <br /> E <br /> TO SCHEDULE CALL (209) 982-4298 9267 <br /> SALES COPY .s ar <br />