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Recycled ftper <br /> RECEIVED Au u 2 6 1992 <br /> r <br /> JVORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 0?349 <br />-Generator <br /> Add ress { zz <br /> ' <br /> Phone ( �� - L �� Contacts r <br /> Transporter <br /> Address <br /> Phone (,Acq) - (- n f Contact <br /> hereby certify that the above named material was picked up at the generator site listed above <br /> Driver Signature <br /> Shipment Date 's - <br /> Truck No �30cQ- - Load No <br /> Vehicle License No/State ..14 3 72fe:) , A Sb b <br /> C5�/ A <br /> onsultant/Cantractor --- — <br /> Address <br /> Phone ` - _='fir '� Contact r Pn <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in propercondition <br /> for transport according to applicable regulations <br /> Name Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by <br /> Date <br /> Acceptance Nom-r- � <br /> This load contains soil with <br /> less than 100 ppm greater than 100 ppm <br /> DOPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> ENTRY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yards Per this Load <br />