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14DtyCltd <br /> FOf�WA„ N�O�V�WAZARDOUS WASTE, DRIVER IDENTIFICATION FO�iM : <br /> f <br /> 1- 1j I f 4. <br /> k t .rIK <br /> Generator: GEQ F. SCHULArR _ <br />'Address. 1705 N• BROADWAY <br /> Phone ( 203) 948 5500 Contac#: P Y <br /> y i ',l(SJC " j l 3 <br /> ,, ,'..'Tx Sr�.,,K e7iF•� � l a '�r '�,� t k,TRU <br /> Transporter: <br /> cB � <br /> R1 K'—HAMILT0N T€3 N6 , <br /> Transporter., r �> <br /> 1336 IaAU <br />'Address: LINE AVE CA` 9351 <br /> Phone: l 209}`_ X578 410Q > Goritac#: SCOTT MEL.1,_OR <br /> tl hereby certify that the above named material was picked up at the generator site listed above.- <br /> Driver Signature: <br /> bove.DriverSignature: <br /> r� R <br /> Shipment-Date: <br /> Truck No.: T � Load N4.: 07 -------.��_.—_ <br />'Vehicle License No./State:" - .`, /C1�j____-- <br /> ►ultantiContractor: . �,[f�F SEMCP <br /> Address: X729--�_ tarn 5 _ <br /> lhone: ( 209) , 979 Al 118 Contact: MIKE irs nus=RJ]a, <br /> kI hereby certify that the above named material is consistent with the information presented iii the Waste-Character-izationTorm <br /> ondtContaminated Scil Description Forrim;andhasbeen properly described,classified and packaged,andisi,mpropi.rconditicir,rransport according to applicable regulations.- <br /> am <br /> egulations: <br /> ame: Date: f0 � <br /> i <br /> destination: Forward, Inc y i <br /> 9999 South Austin Road: Mante California 95336 <br /> (209) 982 429$ - <br /> , <br /> Received by <br /> t <br /> D Da <br /> acceptance No 42 225 <br /> This load contains soil with T <br /> �� .�•,�-L ,r F. '?,..+ i"�-�•'r•s 'P fi' n-Y_ y -,..La t x t_ r-'. _ <br /> less than.l00 ppmx x greater than 100 ppm. <br /> '{+s +iCv1 ivr f:5'�- .. '.-.-.. ., _�w..•h•� � x1�f,•. a. , < : ;.- ., . ..- r .,,.. - _ y.,.....f. : '.- •'PLZ <br /> y. <br /> OF OF THIS SHEET MUST ACCOMPANY EVERY WASTE'LOAD, AND MUST BE SUBMITTED AT-THE GATE FORA.: <br /> _�. Y.ALL LOADS T�1UST BE SCHEDULED AT't_FAST,24 HOURS IN ADVANCE __ (209)982-4296`LANDFILL DEL,JERIES <br /> MUST SE SCHEDULED ON A DAILY BASIS ANYC'UIJSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> .-..__ :. .-t.C�4"-.•l+ja,+}4y-Yfi � '7, d i# ifG '.'7 f , asr �' •-21 '7 V .,.`'. N p��r -. v�J .1 '' <br />�ard: Per this Load ry <br /> .. .. ,t.. . . _ rFNFRe7ria r:hfaV.. .r' <br />