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Recycled Paper ' <br /> 1 • <br /> jRWARD, INC, NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 03082 f <br /> ! western Lift <br /> Generator: Rank of S c,cic`on Gan er-atirr� l..C]C t4-:)n 34301 S . El <br />(Address: n- D- 0 c x 1110 , St:,�:,c.,i;ton , C:a 0'S2^9 <br />,Phone: { 299 941 _ 137E Contact: John llrrut.;a <br />,Transporter: 'M P Fnvi ronmenta 1 Serv^cns Tnr <br /> Address: 3400 Mencr StF3�k�_rsfiel-' , r, <br /> i <br />('hone: ( 9) S5£i_ 931 6 Contact: Ed Mc•r"'i!ron <br /> - <br /> hereby certify that med m rias w picked up at the.generator site listed above. <br /> )river Signature: <br /> Shipment Date: -- <br /> � I - d} <br /> "ruck No.: _ Load No.:J <br /> iehicle License No./State: <br /> i <br /> Rino Environmgnta3 I <br /> �nt/Contractor: <br /> Adress: p Q Sox 208 F'oiscm Ca . - 95630 <br /> 9 6 983 2241 Ronald K. R=nehtar <br /> ��nane: ( � - Contact: it <br /> Hereby certify that We_ibove named material is consistent with the information presented in the Waste Characterization Form <br /> id Contam)uated Soil De ription Fob and h been properly described,classified and packaged,and is in proper condition <br /> it transpo acdording t a licable r g lation .N <br /> ame: . <br /> . Date: � 3 <br /> r 1 <br /> �stinatian: Forward, Inc. <br /> f{i <br /> 9999 South Austin Road, Manteca, California 95336 ' <br /> (209) 982-4298 ;I <br /> Received by: <br /> Date: r <br /> ceptance Na.: �2_173 <br /> 's load contains soil with: <br /> Gas 'arid <br /> if <br /> tees than 100 ppm greater than 100 ppm }}i <br /> I <br /> ' -)IMF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> L LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE: (209.-)982-4298 LANDFILL DELIVERIES <br /> ST BE SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br /> . Fit <br /> s Per this Load: <br /> 1 � <br /> l •f -- TRANSPORTER COPY <br />