Laserfiche WebLink
WA -HAZARDOUSRD NONWASTE MANIFEST <br /> WASTE ATMENT AND DISPOSAL FACILITY <br /> GENEIIJOB ACCEPTANCE NO. 93 — 5:3 <br /> AATbR � � <br /> ' + REQUIRED PERSONAL PROTECTIVE EDUiPMENT <br /> - Q GLOVES [:]GOGGLES ❑RESPIRATOR ❑HARD <br /> - MARLING A$DRESS_ t Y -- M'-_" ❑TY-VEK MOTHER <br /> CITY. STATE,ZIP " '�" - "" " T SPECIAL HANDLING PROCEDURES <br /> • y ., ,..e .. -- - C. a 8 <br /> 'PHONE <br /> SSD: -.T-23G,3' <br /> CONTACT PERSON _ - <br /> ✓U;1a0 L�+�Ci.i iia - •- .•••••' _•• <br /> SIGNATURE OF AUTHORIZED AGENT/TITLE DATE <br /> *17/`r <br /> WASTE TYPEV RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • L] DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> E] OTHER <br /> MANTECA, CALIFORNIA 95336 <br /> GENERATINGFACILiTY (209) 982-4298 PHONE <br /> Tracy , CA <br /> as :-CBiL4. (209) 982- 1009 FAX <br /> NAME <br /> Ilard-Tr..c:ci:.4, Tn�. — -_ �� N NOTES _ TRUCK NUMBER <br /> .C., <br /> ADDRESS <br /> F.C. Boy. 2:' <br /> E. Ra,�La:i <br /> . CITY, STATE,ZIP <br /> : Br roc., CA 9-.5". <br /> PHONE J V j tt e� _� END DUMP BOTTOM DUMP TRANSFER <br /> i L 3 i y 3 J V •••,• •• •. .. <br /> . , SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL (S) FLAT-BED VAN ---bRU❑MS <br /> , <br /> f ❑ <br /> C] El <br /> FORWARD INC, LANDFILL CUBIC YARDS <br /> Laaaa'i+C Yar48 <br /> Forward shall have no obligation to accept the waste if weather or other 148 <br /> conditions impair the safe and effective disposal of the waste or I the waste DISPOSAL METHOD <br /> impairs the safe and effective operation of the Landfill Forward shall use (TO BE COMPLETED BY FORWARE <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE -810 AERATE MWXPU OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on v - - <br /> weather or other site condrhons, 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 ❑ <br /> REMARKS "` _ ��..' � - ._.m.-_,..,�---�,.,.,. �T _y SLUDGE <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER - � - �" "'' ASBESTOS <br /> mss.�-- �__. ❑ WOOD <br /> SIGNATOR F AUTHORIZED AGENT ' .' ^ DATE "•.' <br /> I _ r ____ .� _,__ ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 <br /> PM 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 11400 <br />