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�� ` NON-HAZARDOUS WASTE MANIFEST <br /> �� WASTE TREATMENT AND DISPOSAL FACILITY <br /> • <br /> .�■ . ,. ,.-JOB ACCEPTANCE NO. <br /> F <br /> GENERATOR� r �� ,- - -- �p~!��;; REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 0 I [:I GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING AC'J��yiCI ❑TY-vEK ❑OTHER <br /> CITY,STATIRZ}p" Q =" - - ==�- SPECIAL HANDLING PROCEDURES <br /> • <br /> PHONE <br /> CONTACT PERSONr <br /> ti AYM .11J <br /> SIGNATURE OF AUTHORIZED AGENT / TITLE DATE <br /> WASTE TNVe 4C RECEIVING FACILITY <br /> 04:t< <br /> ❑ SLUDGE <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISP� �IL ❑ 9999 SOUTH AUSTIN ROAD <br /> •CONS C ON 501E ASH <br /> • 4, ti ❑ ASH❑ OTHER MANTECA, CALIFORNIA 95336 <br /> (209) 982-4298 PHONE- <br /> - - J - (209) 982- 1009 FAX <br /> NAME - _ .__ NOTES TRUCK NUMBER <br /> ADDRESS <br /> . CITY STAT! ,_Xf, <br /> PHONE - . 7- . - END DUMP BOTTOM DUMP TRANSFER <br /> ❑ ❑ ❑ <br /> ' SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLATBED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cuBlc YARDs ,�_, <br /> Forward shall have no obligation to accept the waste rt weather or other , <br /> conditions impair the safe and effective disposal of the waste or if the waste <br /> impairs the safe and effective operation of the Landfill Forward shall use DISPOSAL METHOD' (TO BE COMPLETED BY impairs <br /> OF <br /> reasonable efforts to promptly notify Desposer of its matslrty to accept the 1310 AERArEjSM6iiLd= <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 " <br /> conditions are expected to change such that Forward Moll be able to Accept <br /> the waste - ❑ SLUDGE <br /> ` REMARKS <br /> ~ T ❑ NON-FRIABLE <br /> FACfJITY TICKET MUMBER -- --. - ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT w _�� - DATE.: - <br /> ---' i' ❑ 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 /> t TO SCHEDULE CALL (209)982-4298 MANIFEST C 9265 <br /> SALES COPY <br />