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1 <br /> Recycled Paper <br /> VLFOL'RIWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 03044 <br /> Generator �L �''1}`- ` t +-� L.J <br />' Address <br /> 11 r CJTt- <br /> Phone (��) ��� - 3�7�' _ Contact <br /> Transporter iP. J l P_i )z 7I1— <br /> Address P_Ib-�Cyp_ igi�' F—P-14-:16 F'li:_T'> <br /> Phone (-I IG) _ Z 1 Lp Contact _E-32 i�-�-Ii 1 <br /> 1 hereby certify that the above named material was picked up at the above <br /> Driver Signature <br />' Shipment Date ti <br /> Truck No 4 i T Load No <br />' Vehicle License No/State <br /> 16 cultant/Contractor -jzi Kx) 'Ii�sV �-- <br /> Address 'PO ale__r�Phone (,:) )L,)1�} 3 _ 'd-2 , <br />' Contact 'cJyEJ <br /> I hereby certify that the above named materiahs consistent with the mformation 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 transpo a cords applic regu6ations <br /> Name <br /> Date <br /> Destination Forward, Inc <br /> 9999 South Austin Poad, Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by -1 (.A )I a'e �, _ <br /> I Date La - 2- q 'Z— _ <br /> Acceptance No 92- - 1 7 <br /> This load contains soil with <br /> less 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 /> r HY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> IYards Per this Load <br /> I - <br /> TRANSPORTER COPY <br />