Laserfiche WebLink
t <br /> �11� ' NON-HAZA US WASTE MANIFEST <br /> i ;._ kT0Rw, <br /> WASTE TREAIMNT AND DISPOSAL FACILITY <br /> CORR.�O�.ATED <br /> :., .,kS ACCEPTANCE NO. 744911 <br /> ENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> L7#}�r vi:m Chl E)GLOVES C]GOGGLES []RESPIRATOR Q HARD HAT <br /> ' MAILING ADDRESS _ ❑TY-VEK []OTHER <br /> 2&a'•iidt8k `C oud <br /> CITY,STATE,ZIP SPECIAL HANDLING PROCEDURES: <br /> � S;--r:.:Situ Fr=j,•-i_+=:Clk 94fJfs0 <br /> - PHONE <br /> ' CONTACT PERSON <br /> lli,V <br /> SIGNATURE OF AUTHORIZED AGENT// TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • F� DISPOSAL SOIL p WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 SIRE01 (209) 982- 1009 FAX <br /> .NAME TRACTOR L1C. i'- TRUCK NUMBER <br /> ADDRESS TRAILER LIC_# / <br /> >•`•:;rt C�':_1t.:_�:,���int f lJ Y��i j` .r I <br /> • CITY,STATE,ZIP TRAILER LIC.# <br /> PHONE END DUVP BOTTOM DUMP TRANSFER <br /> i � 4-Iss l°��� ❑ ❑ <br /> SIG NATURE�AUTHORIZE_D AGE OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <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 <br /> reasonable efforts to promptly notify Disposer of its inability to accept the , - DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason, If Forward's 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 f=orward will be abie to accept <br /> the waste. p SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> .. ❑ <br /> FACILITY TICKET NUMBER ASBESTOS <br /> t _... .d,'.-• ❑ WOOD <br /> SIGNATURE OFAUTHORIZED AGENT DATE , <br /> J . 4 ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST'BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL 0 ANY UNSCHEDULED LOADS ARE <br /> F <br /> UBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> O SCHEDULE CALL (209)982-4298 <br /> 071CQ5��Nt•f)5.96 SALES COPY MANIFEST # C ��+v i�v 0 <br />