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NON-HA <br /> FORWAM, <br /> LA <br /> RDOUS WASTE MANIFEST <br /> INCORPORATED WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB Acc <br /> GENERATOR , " " I 1EQUIRED PERSONAL PROTECTIVE EQUIPMENT, <br /> i1� �`;< 1S GLOVES ❑GOGGLES ❑RESPIRATOR C3 HARD HAT <br /> .. �w ,.: °; TY-VEK -]OTHER <br /> MAILING ADDRESS' <br /> � m � x <br /> tA4_ n0C7Ej <br /> �,. n <br /> g ' Y PECIAL HANDLING PROCEDURES: <br /> CITYP ' t ZA . <br /> .:, <br /> S(av) ALS9L4lo�-I <br /> . :. j!- <br /> �115_ +(os ti�a <br /> E CONTACTPERSON <br /> _. <br /> c,lna�c� P,v <br /> ._. _. <br /> SIGNATURE OF AUTHORIZED AGENT% TITLE DATE <br /> l <br /> )Atm; <br /> ® WASTE,TYPE,. " o , � f, r .. ECEIVING FACILITY . <br /> _.:. _......�, _ <br /> ❑ SLUDGE <br /> �r ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ® <br /> DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> ,n ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (-A (209) 982- 1009 FAX <br /> i ,; NAME NOTES: TRUCK NUMBER <br /> ADDRESS <br /> CITY,STATE, ZIP A <br /> -'PHONE END DUMP BOTTOM DUMP TRANSFER <br /> I. zC1 S=9- -L-L-L t <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE w ROLL-OFFS) FLAT-BED VAN DRS <br /> _ �ry ❑ ❑ El <br /> FORWARD INC. LANDFILL CUBIC YAR/vs <br /> Forward shall have no obligation to accept the waste if weather or other //// L = <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <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 c..�� �. DISPOSE BIO AERATE SrOcxPiuE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on 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 NON-FRIABLE <br /> ASBESTOS�. ❑ AS <br /> BES70S <br /> FACILIT'�. <br /> • Y TICKET NUMBER' <br /> SIGNATL�I�E�. .. <br /> ❑ WOOD <br /> OFAPTHORiZED AGENT DATE <br /> f ' <br /> ❑ ASH <br /> ❑ OTHER I t <br /> , <br /> SCHEDULING �iIUST SE :MADE PRIOR TC/4:00 PAIL THE DAY PRIOR 'O _XPE�:iED .ARRIVAL a ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON AaRRIVAL.OINGCIN'G 191'U! C'EL;VERIES= UST BE SC�EDUL=T� 'VI TH TIHE L.A.Nj DFiL?T.-iE CA'11 3E,:_GRE. <br /> TO SCHEDULE CALL (209) 982-4298 <br /> MANIFEST # '7 •r� �. <br /> GFUEBATORY- <br /> \ <br />