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® Recycled Paper <br /> 9AWARD9 INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 43070 <br /> N stern L..W ft <br /> Generator; Bank of Stockton GFnprat;n,-w I.c�cat iC,rl . 34^(� ) . wl �i.rc d'c <br /> P. 0 Box 1110 , Stoct.nn , Ca . _,y _ <br /> Address: <br /> Phone: ( 299 941 1375 Contact: <br /> Transporter: M R En,.( ronmenta1 Serv:lcr-_s inc . <br /> 3400 Manor St . , Oakers , -ic c' , Ca . 9�1 „0 <br /> Address: <br /> Phone: ( 9)6 668 _ 4316 Contact: <br /> I hereby certify that t �am� /m aRatQ as picld~d up at the generator site listed above. <br /> Driver Signature: <br /> Shipment Date: f <br /> Truck No.: 22 Z / D �L - --Load No.: <br /> Vehicle License No./State: <br /> Ft;r6 Er.v-i ronmental <br /> ultant/Contractor: <br /> Address: p_ O . Box 204 , Folsom, Ca . 95630 <br /> 916 983 2241 poi a ,d K. Rinehart_ <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 Form,And has been properly described,classified and packaged,and is in proper condition <br /> for transpo%11E <br /> g1t applica ! reg tions. <br /> Na __e* Date: <br /> Destination: Forward, Inc. <br /> 9999 South Austin Roa�, Manteca,.California 95336 <br /> (209) 982-4 8 <br /> Received by: <br /> Date: <br /> Acceptance No.: C'2 173 <br /> This load contains soil with: <br /> Gas and � <br /> of ecel Contami nat f-d4g than 100 ppm greater than 100 ppm <br /> A,r ')PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> 6*,- Y.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 /> TRAF3SPORTFRCOPY , <br />