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c f ® Recycled Paper <br /> rORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM.. . <br /> 03097 <br /> e_3tern L!I, - <br /> Generator: eanl< of Stockton Gener-atisncg Loca-k inn : 3430 S. El Dorado <br /> P. O. Box 1110 , Stockton , Ca . 95209 <br /> Address: <br /> Phone: { 20? 941 _ 13 7i Contact: 'John IJ r r kj t i a <br /> i <br /> Transporter: M p Envi ronmerltz-)-l. Ser�vi ccs Inc - <br /> 3400 Manor St - , 9a kers i e ,ci , Co . 2330 0 <br /> Address: <br /> Phone: _ 1--dd Morrison <br /> 6 6 8`� 931B Contact: <br /> I hereby certify that the above n e ateria, picked up at the generator site listed above. <br /> Driver Signature. <br /> Shipment Date: <br /> �G <br /> Truck No.: Load No.: <br /> A�3 <br /> i <br /> Vehicle License No./State: < < <br /> Rino--Env'ir(ihm— <br /> *ultant/Contractor-- <br /> Aa(iress: P- O_ 3ox 7t]8, (-aiscm, Cm . 95f30 <br /> 916 983 2241 Ronald K . Rinehart <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 Contaminated Soil Description form,and has been properly described,classified and packaged,and Is in proper condition <br /> for trans�a accarin to applica regula i <br /> Name: Date: - <br /> Destination_: Forward, Inc. <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 , <br /> Received by: <br /> Date: <br /> . toi <br /> ' rl <br /> Acceptance No.: 2 1 7 3 <br /> This load contains soil with: <br /> �- Das and <br /> Diesel ContamihatPf6s than 100 ppm greater than 100 ppm <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 LANDFLLL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br /> Yards Per this Load: - <br /> ` ''� TRANSPORTeR,GOPY'"~ <br />