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FORWARM NON-HA EATDOUS WASTE MANIFEST <br /> �+b I N C O R P O R /A 1" L I7 WASTE TRMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO, <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 8toc]dm Pekolmm COD4=Y GLOVES ❑GOGGLES [:]RESPIRATOR HARD HAT <br /> MAILING ADDRESS HTY-VEK [:]OTHER <br /> 1903 Navy Dnve SPECIAL HANDLING PROCEDURES <br /> CITY,STATE,ZIP <br /> Stacktoq CA 15206 <br /> PHONE <br /> (209}462-8707 <br /> ON ACT PERSON <br /> Jay MCUTO& <br /> SIGNATURE Q AUTHORIZED AGENT / TITLE DATE <br /> �c C�VE <br /> • WASTE-TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> * DISPOSAL SOIL ❑ WOOD <br /> CONSTRUCTION SOIL' ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 3300 West Lane,SWdcxM CA <br /> (209) 982-- 1009 FAX <br /> NAME y TRACTOR LIC # 1/176f�•5 TRUCK NUMBER <br /> Bob Evm� G P47--ar.f4 J/zr]A, <br /> ADDRESS TRAILER LIC 74 j-1 <br /> 21010a,hfoam Roan! _ c7 <br /> • CITY,STATE,ZIP TRAILER LIC # <br /> • — CA 9533,7_ -- `LrG i 1�',t,,. AR 7i <br /> PHOS _ END DUMP BOTTOM DUMP TRANSFER <br /> • 39-34071- C'-c- s z1:1_ 1:1 1:1SEGNA�URE OF AUTHORIZED AGENT OR DRIVER DATE_ ROLL-OFFS) FLAT-BED VAN DR <br /> UMS <br /> _ _ ❑ ❑ ❑ ❑ <br /> r <br /> YAR4 <br /> k FORWARD)NIC. LANDFILL ' BIC ° <br /> L <br /> Forward shall Live no ob4gation to accept the waste if weather or other y <br /> conditions impair thersafe and effective disposal ot the waste or if the waste DISPOS METHOD (TO 13E COMPLETED BY FORWARD <br /> impairs the safe and effective operation of the t'andfdl Forward shall use ) <br /> reasonable efforts to promptly notify Disposer of,its inability to accept the DISP E O A RA(E STOCKPILE OTHER <br /> waste for any reason If Forward's refusal to accept the waste is based on — <br /> weatWr or other slte conditions,Forward shall notify the Disposer when site SOIL <br /> • 1.coy t ns are expected to change such that Forward will be able to accept <br /> f e waste <br /> � MARK54 - --- -T --�— — -�----_ - [:1 SLUDGE <br /> ❑ NON-FRIABLE <br /> �- --- ASBESTOS <br /> __ _ __ ❑ WOOD <br /> OF ALITI j RIZED AGENT DAT w fr{ <br /> ASH - <br /> Cc , <br /> OTHER <br /> , <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LQADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL <br /> (209)982-4298 GENERATOR Copy 624660 <br /> rat IC951 INH)6 96 MANIFEST # C <br />