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® Recycled Paper RECE!tf_,D 1,s., 2 6 19 <br /> 92 <br />.6FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> ©1896 <br /> Generator C d <br /> Address n <br /> _ 1 <br /> Phone ( 410?1 - c�S"� Contact <br /> Transporter <br /> Address "''Z 222 <br /> Phone jP0`) C _ - ` d Contact <br /> I hereby certify that the above named material was picked up at the generator site listed above <br /> Driver Signature <br /> Shipment Date <br /> Truck No 2 _—Load No <br /> Vehicle License No/State <br /> o <br /> loultant/Contractor R p &C - :#-41 C <br /> f <br /> r <br /> Address a ' <br /> Phone (a 07) �`7 ;7 - _,7 5'02 --2 __----- Contact - <br /> 1 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 proper condition <br /> for transport according to applicable regulations <br /> Name Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, Callfgmia 95336 <br /> (209) 982-4298 <br /> Received by <br /> Date <br /> I , <br /> Acceptance No <br /> This load contains soil with <br /> less than 100 ppm greater than 100 ppm <br /> I3PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> PRY 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 / 7 <br /> TRANSPORTER COPY <br />