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�J <br /> t <br /> r <br /> y;:msµ ORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> ;01323 <br /> I mc* i �: �s � F h <br /> Generator <br /> Bank of 5tocktor, _` � � 1 � � <br /> Address <br /> Pnx 1 1 10 - C'n 91 2 C 9 <br /> 2 941 1 ^�715 <br /> Phone ( - Contact <br /> Mi 7 r-r✓1 ronme-ntal <br /> Transporter <br /> Address otra n, 9?�0P <br /> q 11 6 S P,8 n?16Contact ^"1 <br /> nn <br /> Phone ( ) <br /> I hereby certify that the above named material was picked up at the generator site listed above <br /> Driver Signature <br />'Shipment Date <br /> Truck No o Load No <br /> Vehicle License No/State s I <br /> losultant/Contractor 1 <br /> Address <br /> P D sox 208 , `-"E'0 <br />' Phone 3- h 1 Contact rt,+n I d K Rinehart <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 transport according to applicable regulations <br /> Name Date <br /> Destination Forward, Inc <br /> 9999 South Austip Road, Manteca, California 95336 <br /> (209) 982-4298 N <br /> Received by <br /> ' Date + 0 -C <br /> ,Acceptance No 92 1711 74 <br /> This load contains soil with <br /> r 1 F p, Cont arnA n I Ass 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 /> �RY ALL 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 /> Yards Per this Load l <br /> TRANSPORTER COPY __ <br />