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Recycled Paper <br /> AWARD, I.NC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> f <br /> 3 03084 <br /> enerator: Bank of �'tOCI<i_bTl Cr,n r� in% I_.bGi t9CJn : ?L 'Q � �Cf'r.�G <br /> ddress: P. O. Box 1110 , L1trjC!<,'_,n , C3 . �1Sry0S <br /> hone: ( 201 941 _ 137 Contact: !r,hn UrrUtia <br /> ransporter: M P Environmental Sery i ccs inc . <br /> 3400 Manor St . , C,�I«rs$�eld , C�, . 933013 <br /> ddress: <br /> hone: ( 91 S) 668 _ 93116 Contact: Ed mo r r 4l S on <br /> hereby certify that thp4bovenamed mater' as puked up at the generator site listed above. <br /> river Signature: <br /> /,/ / <br /> hipment Date: �- <br /> uck No.: - d Load No.: f <br /> hicle License No./State: 00 <br /> r <br /> i <br /> Rina Environmental <br /> -u tant/Contractor: <br /> dress: A- D• Bcx 208 , Folsom, Ca . 05630 <br /> 916 933 2241 Ronpld K. Rinehart <br /> one: ( ) - Contact: <br /> ereby certify that the above named material is consistent with the information presented in the Waste Characterization Form I <br /> d Co F inated Soil Description rm,and has been properly described,classified and packaged,and is in proper condition <br /> r tramp- m accor to applicab regulatlp' <br /> me: [ ) - q , <br /> Date: <br /> stination: Forward, Inc. <br /> 9999 South Austih Road, Manteca, California 95336 <br /> (209) 982-4298 I <br /> Received by: �. I <br /> Date:-- —Ill .. it ��- �`'i�.--• _ <br /> i <br /> ceptance No.: 02- 1 7 3 <br /> I <br />,is load contains soil with: <br /> Gas and I <br /> I <br /> Diesel Cnntami nate4ss than 100 ppm greater than 100 ppm i <br />-AOF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> !Y.ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE: (209)982-4298 LANDFILL DELIVERIES <br /> JST.BE SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. i <br /> I <br /> rds Per this Load: / i <br /> TRANSPORTER COPY <br />