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c' ,1 <br /> Atcycic,i.Paor <br />' FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> Amok <br /> -- - - <br /> � 2 _J'L25 <br />' C--,r F S t <br />'�aenerator: ._.._._-__..._._ 0 �• . _ CH! LAR -- <br /> dress: 1705 N __BROADWAY -- <br />�hone' ( 209) 5500 --- Contact: PR4SLFY SCHULhR <br /> Transporter: RICH HAMILTON TRJCKINtQ <br /> Idress: 1.336 PAULINE AVE . 110DESTO , CA 95051 <br /> Phone: ( 209) . 57$•. _ 4100Cantoct: SCOTT MELLOR <br />�ereby certify that the above named material was picked up at the generator site listed above. <br /> f <br /> ver Signature: _—,ejz�, C - <br /> iPrnent Date: - <br /> Truck No.: `'E Load No.: 12 <br /> 1i <br /> ihicle License No./State:. L� 7 i_S�i A T _ <br /> �Itant!Contractcr: IiE- R M 0 0 <br /> address: P , QQX 6729 MODE'STO GA GS 5 5 __ <br /> hone: ( 203) ti79 - S13A Contact: _... -h"IKF Kt 0VFRE)A'i'tc' <br /> ereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> id Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper condition <br /> r transport according to applicable regulations. E <br /> Tame: Date: <br /> Iestination: Forward, Inc. - <br /> 9999 South Austin Road, Manteca,-,California 95336 <br /> (209) 982-4298 <br /> Received by: - - ! <br /> acceptance No.: 92 - -225 _ <br /> i his load contains soil with; " <br /> L <br /> - less than 100 ppm - greater than 100 ppm <br /> PY OF TH,IS SHEET MUST,ACCOMPANY EVERY WASTE LOAD, AND-MUST BE SUBMITTED AT THE GATE FOR <br /> RY.ALI.LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE: (203)962-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS. AN`( UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br />�ards Per this Load: <br /> 1 <br /> TRANSPORTER COPY <br />