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(t)i;TORWANON-HAZ <br />RDOUS WASTE MANIFEST <br />[iVCUltE ORAT <br />�- , ,A <br />WASTE T MENT AND DISPOSAL FACILITY <br />JOB ACCEPTANCE NO. <br />7' 66321 <br />GENERATOR, •, ,.;:. _ , w <br />_'....<ps.<a ba .?+..4 ..,.:r';' <br />REQUIREQ 9RSONAL_PRQTECTIVE EQUIFNENT„� <br />Qljm. STOP MARF°E'i'S <br />❑ GLOVES ❑ GOGGLES [-]RESPIRATOR ❑ HARD HAT <br />Y <br />MAILING ADDRESS` say <br />` iL•,�y `_ �'w <br />❑ TY-VEK ❑ OTHER <br />..�. a <br />4567 LQ,1TEcRP1ZD"'C a iR .hNT <br />CITY STATE *QIP ' ” - <br />:.. <br />u `� ; r <br />SPECIAL HANDLING PROCEDURES: <br />._........._a_ _ r z... _._... <br />• FRM MONT, C.A.94539 <br />..:oma ut r . <br />10)657-8500 <br />SIGNATURE OF AUTHORIZE® LENT / ITLE DATE <br />/fl d r <br />ASTE TYPE <br />....,. �_:. <br />t = <br />❑ SLUDGE <br />❑ TREATMENT SOIL ❑ NON -FRIABLE ASBESTOS FORWARD INC. LANDFILL,, <br />❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD- <br />❑ CONSTRUCTION SOIL ❑ ASH <br />❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br />GENERATING FACILITY. (209) 982-4298 PHONE <br />QLTM STOP <br />1030 orr$v (209) 982=1009 FAX <br />vxnc,�.Tnr�, c� <br />930 SMLOH ROAD #44 <br />VaNDSOP, CA 95492 <br />(7011) 838-1407 <br />SlG'�'., : E�OF`'QUTHOR�ED A O,OR, DRIVER � " aTmj,4 <br />FORWARD INC. LANDFILL <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 <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 <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 <br />conditions are expected to change such that Forward will be able to accept <br />® ❑ Y <br />®1 <br />the waste. <br />gnaw:. <br />5r )♦ • • <br />; . . <br />' <br />10 <br />• • ' • <br />