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^i 4i1 <br /> ®_Recycled Paper <br /> FORWARD; INC:. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> • <br /> 03071 <br /> . <br /> 'vJastern l_ift <br /> Generator: 138n1< of Stock<%on Gancerafi.ng -Locat•i0m : 3430 S . El 0c,radL3 <br /> P. 0. sox 1 1 1 0, Stccl<ton , C, _ 0 205 <br /> Address: <br /> Phone: ( 20P 941 _ 1375 <br /> Contac#: John U rut i <br /> T - I <br /> Transporter: P En vi ronmar-, a 1 Servi Ces <br /> 3400 Manor 5t_ . qal<ersfield , Ca. - 93303 <br /> Address: <br /> TL <br /> Phone: ( 915 S58 - 9?1 F Contact: `=d Darr;son <br /> ` l he?$by certify that the abov mat i /as picked up at the generator site listed above. <br /> Driver Ngnature: , <br /> Shipment Date: ' <br /> Truck- r Y Lead No �'' - <br /> Vehicle License No./,State: 4, <br /> i _'rte a�.,a " `: i , a "• ' + <br /> v <br /> ron en <br /> ny <br /> Co" sultan_t/Contractor:" <br /> 4 <br /> C Address: `�'_ 0." Sox ?tl8 Fb1som; Ca . X5630 <br /> I 9t6 983 224' Ronald K_ Rinehart <br /> i !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 Soii Descrip(ion Form,a has been properly described,classified and packaged,and is in'proper condition <br /> for trapsport`a cording pplicab regul ions. ` <br /> lUame <br /> Destination.. Forward, Inc,'" . <br /> 9999 South Austin Road, anfeca, California 95336 <br /> .t <br /> - . (209) 982-4298, • ' <br /> Received tiy: 77 ,. <br /> Date: <br /> Acceptance No:: 192 17 3 } <br /> This load contains soil with: ; <br /> Gres and <br /> ^Deese I C::Qr)tam-Tnntc{ts than 100 ppm greater than j00 ppm',. , <br /> A COpY OF!THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST.BE SIIBMITTED AT-THE GA�E FOR, <br /> ENTRY.ALL LOAbs MUST BE SCHEDUC�Ef AT LEAS�''d,4.HOUF�S IN ADVANCE:.:; (209)982-4288 LANDFILL DELIiYERI s � <br /> w=-M1�S $E•SCHEQULED_ON_�4 4�1l4)I ,S�S;/A -Y�.UNSCHE9 LED LOADS MAY BE REFUSED.AT THE GATE. <br /> Yards Per this Load: <br />