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Ark <br /> kvRecycled Paper <br /> JRWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> _stern L_ <br /> 03088 <br /> Getterato(, 8iank of Stoci<ton Gcncrc` =ng Loc•atic)n . =430 s _ El I)c,rzdo <br /> t <br /> P_ 0- Box 1110 , oc < .on , Co - <br /> Address,-L, <br /> o _Address:_' - <br /> Phone: ( 20P 941 _ ? ^75 .!.n.hn Llr-rut1in, <br /> Contact: <br /> I <br /> Transporter: M P Envi ronmGn}al srvict :nc _ <br /> 34od Manor St Bakersfield , J.JJVW <br /> I Address: - <br /> 668 ^.315 ` r' I�ltarr;mon <br /> Phone: ( - Contact: <br /> j I hereby certify that the-above named mderial was picked up at the generator site listed above. <br /> I - <br /> Driver Signature: <br /> J <br /> I Shipment Date: -' <br /> . Truck No.: Load No.: <br /> Vehicle License No./State: <br /> l <br /> 1 Rino Environmpnta <br /> jultant/Contractor: <br /> I; Address: P_ 0 - 3ox 208 , Folsom, CO . 25520 <br /> 916 9$3 2241 ; K• <br /> i Phone: ( ) - Contact: <br /> I hereby certify that the above named materia As;consistent with the information presented in the Waste Characterization Form <br /> and Cont inated So' escription rm,an hap been properly described,classified and packaged,and is in proper condition <br /> for transpo accords g o applicab a regulat ns. <br /> Name: Date: <br /> E + <br />'I Destination: Forward, Inc. <br /> - 9999 South Aust1710z4"" <br /> Manteca, California 95336 <br /> (209) 982-4298 Received by: - t <br /> Date: r <br /> Z_ <br /> k9.2 1 7 3 <br /> _Acceptance No.: <br /> E <br /> This load contains soil with: <br /> Gas and <br />�i Diesel ContaminatleAthan 100ppm • greater than 100ppm <br /> PY OF 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 /> MUST Bi=SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br /> II� <br /> .Yards Per this Load: <br /> TRANSPORTER COPY V <br />