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1 � n FORWARD NON-HAZARDOUS WASTE MANIFEST ,�} FORWARD NON-HAZARDOUS WASTE MANIFEST INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY J I N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FAC.IUTY JOB ACCEPTANCE N0. C ;i��;, s?2~= JOB ACCEPTANCE N0. GENERVORl.G�. EOWMENTPL r ©GLOMES ❑COe(LES❑RESPRAO ❑C HARD HAT❑GLOVES ❑GOGGLES 13RFSPMTOR ❑HARD HAT WAILING _ _i ' ❑TY V ©EK ❑OTHER TY VEK ❑OTHER P Q U`7-_-4 SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES CITY STA ,'.� Ers.irnp x ^��te� • C �� 5 S 3��z s - PHON 2c5 -c�t CONN f_PERSON— - �'�yr`.• vc-K -r SIGNATUREOFALMi D'AGENf%TITLE_ DATE" '—�_ SIGNATIJ OF AGENTITiTLEwE DATE - * � VYASTE TYPE RECEIVING FACILITY VOSM TYPE RECEIWJG FACUM 4 ❑ SLUDGE ❑ SLUDGE [:1 TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL TREATMENT SOIL [) NON FRIABLE ASBESTOS FORWARD INC LANDFILL - ❑ DISPOSAL SOIL ❑ WOOD ❑DISPOSAL SOIL ❑WOOD 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOILASH 9999 SOUTH AUSTIN ROAD ❑CONSTRUCTION SOIL C1 ASH ❑ OTHER MANTIwCA, CALIFORNIA 95336 5QTHER MANTECA,CALIFORNIA 95336 l`L _ GENERATING FACILITY (209) 982-429$ PHONE GENERATING FACILITY (209)982-4298 PHONE ( (209)982-1449 FAX 209)982-1009 FAX NAME NOTES TRUCK NUMBER [JAHIE ,� NOTES TRUCK NUMBER - y cj L �,t,'L- r Ij L ADDRESS o),f_ 3 y c, S ADDRESS y5 CITY STATE CITY STATE zIP �,%..�.S�� - rtir�t,c� C � 35Y PH - r, r PHONE t EN P BOTTOM DUMP TRANSFER END DUMP BOTTOM DUMP TRANSFER 4 I LS_ Ld., ❑ ❑ ,C�l"" -slit r ❑ El SIGNATURE NT DR DATED 1 ROLL-OF'FIS) FLAT-BED VAN DRUMS �GNATURE~OF� ORtZED AGENT OR DRIVERJ7DATE ROLL-OFF(S) FLAT 0 DRUMS 71C /I /c'D l�S ❑ ❑ ❑ ❑ FORWARD INC LANDFILL CUBIC YARDS FORWARD INC LANDFILL CUBIC YARDS 1 -- Forward ahem here no ad hon to accept fne waste d weedier or other I I 1 forward"I have no o0lpatmn to accept the waste d wea=ner or other i 5a cww�tmns anpan the sale and etteclm disposal of the waste Or d the waste DISPOSAL METHOD {TO BE COMPLETED BY FORWARD) c"lom aro"the sate and etlect"disposal at the waste or d the waste DISPOSAL METHOD TO BE COMPLETED BY FORWARD) arylars the sate and ellectm oparahon at the Landnm Forward sham use OtSPOSE AEIUTf SIGCKPaE OTHER nparra Lha safe and atlectrre operafm of the Lardh6 Forward&W use reasonable asoma to prompfty notify Disposer of its■mbmy W aCcepl Me reasonable eflorts to promptly o Wy Daposer of 4s elabeay to accept the DISPOSE1 BIO I AERATE SIOCKPSE OTHER waste tor,,,y,saw It Forward s retusal to accept the waste.s based on waste Lor airy reason.d Forward's rahaW to accept the waste a lased on wealher or other aIle CMd,ton Forward Shea nowy the Disposer when Ute ❑SOIL weather or other the Conddlons Forward shall noldy the Daaposef when site ❑SOIL cDnda*m are expected t0 CANge such thar Forward vem be able to accept condemns are expected to Charge ouch that Forward eaa be able W accept the waste Q SLUDGE the waste ❑SLUDGE REMARKS - REMARKS ❑NON F LM NDN FRIABLE I ❑ASBESTOS ; FACILITY TICKET NUMBER GS FACILITY TICKET NUMBER --- - � ❑WOOD SIGNATURE 1ORtZLU AGEN1�'\ DATE ❑WOOD SIGNATURE OFICUTFtORLZED AGENT, DATE ❑ i' I 3 ; ❑ASH * j 0-0THASHER SCHEDULING MUST BE MADE PRIOR TO 400 PM THE DAY PRIOR TO E%PECTED ARRIVAL-ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 4.00 PA THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAYBEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL.THE DAY BEFORE TO SCHEDULE CALL(209)982 4298 MANIFEST- 53032 TO SCHEDULE CALL 1209)982 4298 MANIFESTO 53031 GENERATOR COPY GENERATOR COPY