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" Recycled Paper <br /> E <br /> , FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 01067 <br /> ;gestern Li ct <br /> O <br /> fetor: Bank of Stockton Cn4nnernting Location : :3430 S_ r:l Dorado Ij <br /> 0 13 six 1 1 10 StacTo;ton , 'a 9 5 2 09 <br /> Address: <br /> Phone: { 2 0).9 - 941 _ 1375 Contact: J n h in !jr r U t-i s <br /> Transporter: M p Environmental Servi;es inc, <br /> 3400 Manor St . , Sakers^F ie?d , (:a _ ^?300 <br /> Address: <br /> Phone: { S 1 6 6 f3 _ 9 3 1 6, Contact: <br /> I hereby certify that the abovnam d rri i l as picked up at the generator site listed above. <br /> Driver Signature, <br /> 0-7 <br /> Shipment Date: <br /> Truck No.- �Mo Load No.: <br /> Vehicle License NodState:_, <br /> FZino .Envi ronmenta I i <br /> k'_.,sultant/Contractor:-- - <br /> Ad 'P- O'. Bax 208 , Folsom, Ca , X35630 <br /> 946 983 2241 Ronald K _ Rinehart <br /> PhD e: ( ) Contact: <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> ;and Contaminated$oil Description F¢rm,and has been property described,classified and packaged,and is in proper condition <br /> for transport aqf4rding to licsble rVati n . <br /> Name: Date: - <br /> 7estination: Forward, Inc. <br /> 9999 South Austin Road Manteca, California 95336 <br /> (209) 982-4298 ` <br /> Received by: <br /> Date: <br /> cceptance No.: - 9Z. 1 7 3 <br /> his toad contains s 'I with: <br /> Diesel •Contaminat rejss than 100 ppm greater than 100 ppm <br /> a7PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> TTRY,ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE: (209)982-4298 LANDFILL DELIVERIES I <br /> USJ# SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. 4 <br /> rds Per this Load: <br /> TRANSPORTER COPY. <br /> J <br />