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V► NON-HAROUS WASTE MANIFESTFORWAMEN! NCORVORATED WASTE T <br /> AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. ' <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 8tox*tpnPeaoleum C mpa T - - GLOVES ❑GOGGLES [:]RESPIRATOR HARD HAT <br /> 71AAILIN ,-A'DDRESS _ Y ' NTY-VEK ❑OTHER <br /> J9051N+ vyDrm- -- ` SPECIAL HANDLING PROCEDURES <br /> CITY,STATEI ZIP ' <br /> • .)5toc3rto"A <br /> PHONE <br /> (209)462--8707 <br /> oN PCT PERSON <br /> JA's-- a <br /> SIGNATURE OF—AUTHORIZED AGENT f TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY r <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • Il DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> El CONSTRUCTION 501E ❑ ASH ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY 4 _ - (209) 982-4298 PHONE <br /> 3300 west Law,ffWddM CA <br /> (209) 982- 1009 FAX <br /> NAME ux� w TRACTOR LIG # TRUCK NUMBER <br /> ADDRS _ TRAILER LIC # <br /> • CITY, TATE,ZIP _ _ _ TRAILER LIC # <br /> • A- OW� <br /> AHOI E � v Ga��LL r� � END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE _ ROLL-OFFS) FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> $0, . tlr 'V-«a'k e, . , - ­I t Y • 'W— t e <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the pate and effective disposal of the waste or if the waste DISPOSAL METH (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 _ _ D POSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based o S - _ <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 /> • ;��EMARKS_ _ � _.— -----_-- � __ <br /> NON-FRIABLE <br /> FACILITY TICKET NUMBl R ..-— `- ❑ ASBESTOS <br /> ..._._ ,.— _ �-- —_--- -- - - - - -�--- ❑ WOOD <br /> - SIGNATUR F AUTH(SRIZE1) A ENT DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PR(OR O 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAC ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)882-4298 GENERATOR COPY <br /> FO iC9511NH)6 96 MANIFEST # C 624674 <br />