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A <br /> �� _ ' _ �= NON-HA7ARDOUS WASTE MANIFEST <br /> Fr';�r0ftw w WASTE ATMENT AND DISPOSAL FACILITY <br /> INC. <br /> -r JOB ACCEPTANCE NO. 93 <br /> GENERATOR _ � _, a REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ❑GLOVES ❑GOGGLES []RESPIRATOR ❑HARD E <br /> MAILING ADDRESS__ _ _ _ ❑TY-VEK ❑OTHER <br /> CRYO STA1TE,7IP SPECIAL HANDLING PROCEDURES <br /> PHONE _ <br /> • r-tri' --:2 6 3 <br /> CONTACT PERSON <br /> uV14:\3 2e-3q_5cr'- <br /> SIGNA "F UTHORIZED AGENT/TITLE DATE, <br /> V TE TYPE RECEIVING FACILITY <br /> (� ❑ SLUDGE <br /> • ❑,4EATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • j ASH 9999 SOUTH AUSTIN ROAD DISPOSAL SOIL ❑ <br /> ❑ CONSTRUCTION SOIL ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 3788 Ii (209) 982- 1009 FAX <br /> Tracy , ^.; <br /> NAME NOTES - TRUCK NUMBER <br /> •._ t t T_ r r_ - - _ t t #'.;32 '5Z <br /> ViLiOi� LV YLAa;\�, 1L\V. JC/J <br /> ADDRESS <br /> G <br /> .C. Bae. ?av - ]r. oi3iOT► <br /> . CITY,STATE,ZIP <br /> 3;ron' <br /> PHONE _ END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) - FLAT 6ED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> I8 Cubic Yai ue <br /> Forward shall have no obligabon 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 FORWARC <br /> impairs the safe and effechve 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 Forwards 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 Forward will be able to accept <br /> the waste ❑ SL <br /> REMARKS` �' <br /> • �,� _ _ ❑ <br /> FACILITY TICKET NUMBER ASBESTOS_ '. <br /> ❑ WOOD <br /> SIGNATURE O=AUTHOR D AGENT DATEASH <br /> L-�� C3 OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS AF <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFOF <br /> TO SCHEDULE CALL (209) 982-4298 <br /> MANIFEST * 11592 <br />