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I'll J - , �. � JON-HAZARDOUS WASTE MANIFEST <br /> ' WARb <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. I S C <br /> GE ERATO -,u ��, - REQUIRED PERSONAL PROTECTNE EQUIPMEN1T- `'L777 <br /> 1 RI '��0i� OMPANi x f ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HA <br /> I MAILING AE Ips ,vLASMOD„aWD _ ❑TY-VEK ❑OTHER <br /> CITY,STAT! �Y'CA 90240 ~ SPECIAL HANDLING PROCEDURES <br /> _ PHONE 314-92379876_ _ <br /> CONTACT P <br /> AI'm FRIE0R!1CF9 N - <br /> SIGNATU OF AUTHORIZED AGENT /T1TLE DATE <br /> e '0 a-P,&�� 1171 I,—i\— <br /> y BASTE TY�f RECEIVING FACILITY <br /> ea '� <br /> ° ❑ SLUDGE <br /> WREATMLI OIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> &SPO SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> CONS � VN SOIL ❑ ASH <br /> �� ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> NERATA~E177 v 1 - (209) 982-4298 PHONE <br /> -� 7 PACIFIC AVENUE UE (209) 982- 1009 FAX <br /> w y Y-w.,-�.- r - _ , _ ..� <br /> NAME tZ n 'ST ' mAE1QC:nam�sTTo�r,r Thar NOTES' TRUCK NUMBER” <br /> E - - V R <br /> ADDRESS "S�6 G 4 74 r <br /> 930 S'r'.ILDH RD #44 <br /> CITY, STATF?rLS©R CA 95492 <br /> PHONE $38-1407 END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> 7�CGfZe-A!ly /' 07 r <br /> FORWARD INC, LANDFILL CUBIC YARDS _ . _ 2.- _ <br /> Forward shall have no obligation to accept the waste if weather or other ti <br /> conditions impar the safe and effective disposal of the waste or 0 the waste +DISPOSAL METHOD; (TO BE COMPLETED OY <br /> impairs the sate and effectnee operation of the Landfill Forward shall use r <br /> = _ _. <br /> ' reasonable efforts to promptly notify Disposer of rts inability to accept the _ -_ UK <br /> " waste for any reason If Forwards refusal to accept the waste i5 based Orl 'i IL <br /> weather or other site conditions.Forward shall notify the Disposer when srte <br />�i conditions are expected to change such that Forward will be able to accept _ `�- <br /> ; the waste =__ -- - -- - --- -•REMARKS _ ❑SLUDGE _'� <br /> r.�� _ _ Y_r: .�-.- its; . 1- =`p-t^ <br /> - �- NON-FRIABLE _ _ <br /> �" _ T..w'.r�. .s�.c-+r.+ ❑ ASBESTOS ' <br /> FACILfTY TICKET NUMBER - <br /> r ❑ WOOD <br /> - <br /> SIGNATEgBEjOF AUTHORIZER. BATE .. <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS AR, <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL (249)982-4298GENERATOR COPY 9 3 013 <br /> MANIFEST * C <br />