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7 _ Imo• xr� �y }M _r' � � L �S- C.a� � 07
<br /> AeCyCled Paper-
<br /> • � � _ , ,' . .�.� �. --'moi .
<br /> :F
<br />__. _ ZARDflUS.-:WASTE.DRIVER LDENTIFICATI4�I: I`ORM
<br /> ORWARD.;:INC
<br /> NON-HAZARDOUS-
<br /> .0
<br /> ON NA .. .0 2�,1�
<br /> .r
<br /> r� ' �.y, - r t.� Y- . 7�fv -r� s •i{ a� - •1 rr x � l ..
<br />;nerator4 GE �-
<br /> � � ,
<br /> '' 765
<br /> idress: `,4
<br /> r Contact'�sRFS1
<br /> lone_ )i'7.a.a iZVy?'r.,.S1?Yr' '!'
<br /> <..
<br />-ansporter $ Gantact
<br /> one: ( 209 ) ' :' � : ::��,..'':`<;-,' .-•: ...:::-,`: -.• -�.. .. .
<br /> hereby certify that the above named materia was picked;up at the generator site listed above:
<br /> river Signature: —
<br /> ihipment Date:
<br /> Load_No.: .'
<br /> A
<br /> lehicie License No./State:
<br /> ;R .
<br /> ;ultant/Contractor::~ WE
<br /> dress:
<br /> chane: ( 209 ) r g i a R -Contact:
<br /> -ch
<br /> n the Waste
<br /> ereby certify that the
<br /> above named material is consistent with the information presented facka ed,and sa n proper clondit do
<br /> d Contaminated Soil Description Form,and has been properly described,classified and p 9
<br /> or transport actor 'ng to applicable regulations } ^V
<br /> Date:
<br /> )estination: Forward, Inc _ 4
<br /> 9999 South.Ausiin.Raacf nteca', Cal�iornla 95336
<br /> {209) 982-4298'-1 -
<br /> , 1 ! r
<br /> Received by
<br /> . - � +tr�ir�y �;�y$+�33�r£ Y4�aC ` ; � .4+ fi'r _ � I-- s - .�.. -s w i _ af4�`"•
<br /> v r
<br /> }�- Date
<br /> aL P. mis
<br /> � Jl —� ^d�i.A�i"14� }r!'
<br /> g2 X25 t
<br /> acceptance No _.___�
<br /> _ ai:�a-J ,- as 't�`s�'e,•tx*a`f ,}�'s.'�� ,�" �. �9���t - {' y, - srb'✓ r s�; }7}*.,,�" t _ �. -- 't-. f...
<br /> ..y !'d •�-+�,'�'T't n ., ,Tri., f r f",.}� fi ♦ r i} i y�. f"�•' t � c f�; � w_1
<br /> ' •,, � -- t s`s. - •r L�'`3s}, >.i�aY'?:? `r ids. .� a �. mss, ,ir, r -
<br /> ' eesh � •SJxt ft is load contains soil w+ttstf � .�_='�� { '. R `� r } ,�r fa ,�x:`:y ��` = ' r �fti� �s .•5 i.f.��
<br /> t 4 K �+� rester than 100 ppm'
<br /> .iF.7�iG7r ?. - r �
<br /> -less than 100 Y
<br /> - p p '�,s.y;c4.4'+P' na[r
<br /> -?j7 C- `t� y ,h� "GCS ';�.• f.•..d K i '.. . '
<br /> •• Y i .,.� �, �re."5.•y•� F ,� -' : �U. .�a„ r, - r-ir•r+ ".']' ED AT rfHE E'.
<br /> F01���
<br /> xt a ,
<br /> x,. >.
<br /> nt'
<br /> T-BE'SUBMI.
<br /> �pY Of T.;-i15 SHEET MUST ACCOMPANY,.EVERY WASTE,LOAD, AND MUS�.�h. ,•�. ..
<br /> 209 982:-4 296,LANDl=ILL DELiuERlES
<br /> NTRY.ALCLQ/ADSMUST.BESC1-tEDULED.ATLEAST24HOURS-IN AD AhIC _„
<br /> ST BE SCHED0-LED;0N.?A DAIL.Y.BASIS ANY UNSCHEDUCED1 OA MAY.
<br /> BE REFUSE } E}GATE r
<br /> UiaK1*:S Kr«ra r r �l � 1 SFW. r Tytti bn �FAt k �;r f�aih�t%—';F y
<br /> =�rr+iXC rrs . `. _ ,x+3
<br /> s #e?' a,::.-re'G,`t:i.:- `.Jk•'?.-to; X
<br /> a,rds per•th4s �, Fr >-• ti �.� i t h S 3�•x�Y ,._ 'it i--...'
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