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FORWARD � NON-HAZARDOUS WASTE MANIFEST FORWARD Y � NON-HAZARDOUS WASTE MANIFEST I N C Q R P Q R A T E D WASTE TREATMENT AND DISPOSAL FACILITY INCORPORATE D WASTE TREATMENT AND DISPOSAL FACILITY f JOB ACCEPTANCE NO. JOB ACCEPTANCE NO. F„5 pGLovES ❑GOGGLES DREsPIRATOR DHARD ❑GI OVEs ©GOGGLES ORESPIiATOR ❑WIRD HAT []TY--VEK ❑OTHER ❑TYVEK ❑OTHER P aaY 47 P 0 Box 97 EEFF mgr .; x? � �r�SPECIAL HANDLING PROCEDURES SPECIAL HANDLING PROCEDURES t — --- - • �-SCA 9530 , --OHM cr3P3G 2019-957-5981 20G-957-5951 JAN HENRICr,SON JAS. HENBISKSOV SIGNATURE AGENf't SIGNATUREOF AUTHOR®AGENT/TITLE DATE"_-" r_ r:•,:_: • WWM TYPE RECEIVING FACILITY _ _ w - VDZTE TYPE _ v_ RECEIVING FACILITY ❑ SLUDGE ❑SLUDGE j ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL • ❑ DISPOSAL SOIL ❑ WOOD - ❑ DISPOSAL SOL ❑ WOOD gggg SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL p ASH . Q OTHER sT iC"`1L_ MANTECA, CALIFORNIA 95336 13OTHER T�.ti��-- MANTECA, CALIFORNIA 95336 GENERATING FACILITY GENERATING FACILRY L tgCD--� ,t __ '11--CLE 1209}982-4298 PHONE ;__- __ 7,C,__= (209}982-4298 PHONE 1�,_5 -:V-- TO -T (209)982-1009 FAX I� = sal - T �; (209)9$2-1009 FAX NAME NOTES TRUCK NUMBER VAME NOTES TRUCK NUMBER 9f =1 T1' � TG - (3 31 ? w r� } r ADDRESS � C, � � ADDRESS - '22- 4J^t hpL•1L- i- ,C - -5 CITY STATE,ZIP CITY STATE ZIP - 'IG=STS, C, I VF!-d f�9T , PHONE END DUMP BOTTOM DUMP TRANSFER PHONE END DUMP BOTTOM DUMP TRANSFER SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS SIGNATURE OF AUTHORIZED AGENT OR DRIVER JDATE ROLL-OFFS) FLAT BED VAN DRUMS y r ❑ ❑ ❑ ❑ FORWARD INC LANDFILL CUM 0 'Ds FORWARD INC LANDFILL CUBIC YARDS �- Fwwartl Shall ha-e no obliPlion iD abottot the waste d weather or other Forward shall ftave nD oblgation to accept the waste a weather er ether corrdit,ons mm r the sate and eftec,. disposal of the waste or d the wase DISPOSAL METHOD [TO BE COMPLETED BY FORVWiRDt conditions impair the sale and effectne disposal of the waste wit the waste DISPOSAL METHOD (TO BE COMPLETED BY FORY"Dl cri airs the so a and eflectiwe ODeraoun of the Landfrn forward ihe11 use mipairs the sate anc ellectnee operation of the Landfill itorwaril shall use reasonable erywts to M)m^nolity Dispose of its inability to accept the / =POSE 130 AERATE SMCKPLE OTHER reasonable efforts tr otify p pmntlw nDsposef of its nabNrty to accept isle SPOSE BIO AERATE SI[Y'0111 OTHER waste for arry reason 0 Forward s MuS6 to accept the waste s based on waste to any reason b Farward s refusal to acceet the waste s based on weather or oche sde coq Wz Fwwarc shelf notify Nie Disposer when site OIL weather cr other s Ia condaios Forward shall notity the Disposer when site ❑SOIL COMIM10is die expetkq Ie Carge such tial Fowrdrd will be able to accepf'"' conditions are e>,per W to charW such that Forward will be able to accept e Me waste []SLUDGE the•`ee"e ❑SLUDGE REMARKS MOREMARKS N FRIABLE ❑ NON-FRAM FACILITY'TICKET NUMBER ❑ASBESTOS FACILIT% TICKET NUMBER ASBESTOS D WOOD ❑WOOD SIGNATPRE,E y�HOWZED AQfNT � DATE SIGNATURE OF AUTHORIZED A'or7't�_ DATE / ❑ASH ❑ASH r• ❑OTHER OTHER _ I SCHEDUUNG MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SCHEDULING MUST BE MADE PRIOR TO 440 P M THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THEDAYBEFORE TG SCIREDULE CA-L 5MANIFEST X .I 209)982 4298 5 5 53 3 TO SCHEDULE CALL(208)982 4298 MANIFEST 0 55534 GENERATOR COPY GENERATOR COPY