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WA RD A 1�. NON-HAZARDOUS WASTE MANIFEST <br /> u'r I ft- WASTE =ATMENT AND DISPOSAL FACILITY <br /> lC� JOB ACCEPTANCE NO. 1:3 <br /> Fl� RATOR" �,� : t_. REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> ❑GLOVES ❑GOGGLES ❑RESPIRATOR ]HARD r <br /> G ADDRE�S. `=_ ;« - ❑TY-VEK ❑OTHER <br /> 5 TEZIPSPECIAL HANDLING PROCEDURES <br /> iOWGi V.'y r.w'rt Vr-. +ti..... ti,• i V <br /> i <br /> CONTACT PERSON R_ <br /> VVii.7 Fad.lDeli <br /> SIGNATURE OF AUTHORIZED AGENT /TIFLE DATE <br /> .. &. <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> • TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> j DISPOSAL SOIL p WOOD <br /> El CONSTRUCTION SOUTH CONSTRUCTION SOIL ❑ ASH AUSTIN <br /> ROAD <br /> • ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATIVGFACILITY (209) 982-4298 PHONE <br /> Unocal stai:loa <br /> Sr <br /> 3733 Tracy Bl,d. (209) 982- 1009 FAX <br /> lzac�" CA <br /> NAIxIE, , -�� -- , , _ - M NOTES ' ,»� ¢¢ TRUCK NUMBER <br /> L11;04F 4+uV.h arlg11L.-- JV43 �L1Jr/ IlY <br /> ADDRESS w r �r1 3 C) <br /> P <br /> S -V. Sar 2 A 3 E. R-EL 1.L. ,,l <br /> . CITY,STATE,ZIP <br /> V ron, Com. <br /> PHgL4F1", END DUMP BOTTOM DUMP TRANSFER <br /> �JaLI U3�—�6iJJ ❑ ❑ <br /> . SIGNATURE OF jkgTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> 18 C.bic Yazd. <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 I the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARE <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 OTHER <br /> waste for any reason If Forward s refusal to accept the waste is based on El SOIL <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 /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> �, ,_ _ __,_ ❑ <br /> FACILITY TICKET ASBESTOS NUMBER " <br /> _ �v __ _ _ _ WOOD <br /> SIGNA FrF A ORIZED AGENT DATE - <br /> - -- �_ ❑ ASH <br /> ❑ 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 BEFOR <br /> TO SCHEDULE CALL (209)982-4298 <br /> MANIFEST # <br />