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Recycled Paper <br /> V� I <br /> FORWARD,, INC. NON-HAZARDOUS WASTE. DRIVER IDENTIFICATION FORM.. <br /> 03079 <br /> We-;tarn. Lift <br /> Generator: Bank of Stockton Gr?nerating Locatic ri : 3430 -S. E7 .. f�c <br /> '. O. PDX ! 1 1 0', StocJ<tnn , Ca - 95209 1 <br /> Address: <br /> Phone: ( 2�9 94 1 _ 1375 Contact: John lirruti?, <br /> Transporter: M P Envi ronmen'ta l Scrvi ces i^L . <br /> 3400 Manor St . ,, ea-rJ ersf i nl d , Ca . 9;3308 <br /> Address: <br /> ,< <br /> Phone: Contact: Ed Meir r i s on <br /> I hereby certify that the above n ed teri a icked up at the generator site listed above. <br /> Driver Signature: ' <br /> Shipment Date:--,6-- <br /> Truck <br /> ate: f <br /> Truck No,: Q Load No.: 175 <br /> Vehicle License No./State: / 3 <br /> r <br /> Rino Environmental ` <br /> �Itant/Contractor: <br /> Address: p- D.r Box 208 , Folsom Ca . 955^(3 4-' <br /> 916 983 2241 Ronald K. Rinehart A. <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 Contaminat d Soil Dest0ption Form and has been properly described,classified and packaged,and is in proper condition <br /> for transport ar Sd ding tocable �Iation <br /> Date: ` <br /> Destination: Forward, Inc: <br /> 9999 South Austin Road, anteca, California 95336 <br /> (209)_982-4298 . . l <br /> Received by: - tt1�, JA. �'Q. <br /> . <br /> Date:� <br /> Acceptance No.: 92- 173' <br /> This load contains soil with: <br /> Gas and <br /> Di ese 1 Contaminat E114ss than.100 ppm--; greater than 100 ppm <br /> Y <br /> OF.THIS SHEET MUST ACCOMPANY EVERY <br /> _WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> lIS <br /> EM1] Y.ALL LOADS MUST BE;SCHEDULED AT LEAST 24 HOURS IN ADVANCE:_ (;g9)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 /> TRANSPOR7iFi COPY �1 <br />