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i FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> Cabkz, Dif-tr, hut,ng 01368 <br /> Generator ganl< of Stockton Ge-nerat -ing l_ocatzran 1149 Vr' WC,be r <br />' Address <br /> Phone ( 205 941 _ 1375 Contact John Urrutic <br /> Transporter M P Fn,. ironmental Services Irc <br /> Address 1) ., �- i 9330£+ <br /> Phone ( 9 1 6 5 6 E - 9 31 6 Contact 1=t N Mc'^r i n on <br />' I hereby certify that the ov�e" named material was picked up at the generator site listed above <br /> Driver Signature tv <br /> Shipment Date <br /> Truck No -7 7 - 30 Load No <br />' Vehicle License No/State (o <br /> lsisultant/Contractor Rim.- Emw4rnmmPntAj <br /> Address P- 0 Oox 208 , Folsom, Ca _ 95630 <br />'Phone ( g 1 k _ _ <br /> Contact 1 K . R 7 n F ha r t <br /> I hereby certify that the above named material is consistent with the information presented In the Waste Characterization Form <br /> land Contaminated Soll Description Form,and has been properly described,classified and packaged,and is In proper condition <br /> for transport according to applicable regulations <br /> r <br /> Name <br /> Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by 1 <br /> Date ._ <br /> Acceptance No 9 2 1 7 4 <br /> ks load contains soil with <br /> t � <br /> Diesel Contami nat9 ss than 100 ppm <br /> I - greater greater than 100 ppm <br /> 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)982-4296 LANDFILL DELIVERIES <br /> *3PY <br /> BI"SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yards Per this Load <br /> TRANSPORTER Copy <br />