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' ReCycled Paper RECEIVED AUG 2 6 RT <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 02350 <br /> Generator r CAc7 <br /> Address ) o <br /> Phone { L,� 7p, Contact <br /> Transporter <br /> Address <br /> S s' <br /> Phone Contact` <br /> I hereby certify that the above named} material was picked up at the generator site listed above <br /> ! 1 r <br /> Driver Signature <br /> Shipment Date _ ��{�T�.� <br /> Truck No :? �t - Load No -- - <br /> Vehicle License No/State, 'k:2 V P_ A-0 <br /> Oultant/Contractor , F-i::�/y 19 r1L t S)4—f � <br /> Address - <br /> Phone -- Contact <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 Farm,and has been properly described,classified and packaged,and is in proper condition <br /> for transport according to applicable regulations <br /> Name Date <br /> Destination Forward, Inc t <br /> 9999 South Austin Road, M nJeca, California 95336— <br /> (209) 982-4298 <br /> Received by <br /> r <br /> Date <br /> Acceptance No <br /> This load contains soil with <br /> less than 100 ppm greater than 100 ppm <br /> *PY 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 /> -mAtASPOP-En COP r <br />