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® Recycled Paper <br /> rORWA <br /> RD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 03059 <br /> Generator N L lice-SGC-T � �T' )49 t-J L,3- <br /> Address 1--U �• l i C7 ��-ll�' - C� tz:�-Z�:r-,j <br /> Phone { — _ `7� _ Contact <br />' Transporter,_ `�' <br /> Address �`7t "�s�L <br /> Phone ( 9 1 Contact -> `t <br /> 1 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 Load No 1 <br /> Vehicle License No/State f <br /> 10 sultant/Contractor -#1 f 0 <br /> Address �� (�' 2--c>E> F`c"�i- fit`-' C9 <br /> Phone ( � � .�� _ 0 a; t- I Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and ContamI d Soil D rlptfon For ,and h been properly described,classified and packaged,and Is In proper condition <br /> for transportcc rding f a livable ufatlon <br /> Name rpt <br /> Date <br />' Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 - <br /> Received by <br /> Date -- <br /> Acceptance No _ 17L"- <br /> This <br /> 7`"rThis load contains soil with <br /> l?, less than 100 ppm <br /> greater than 100 ppm <br /> Ajjh�-)PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> AY 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 /> Yards Per this Load _. <br /> TRANSPORTER Copy <br />