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® Recycled Paper <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 03060 <br /> Generator r '#O 1V- zp1"-�t `EZSt� !!�Z-g7t5 ' 1qq L-2� <br />' Address -Pc>• PaFp� 1 (I G t5; -3 - C-P, <br /> Phone 24 1 13-75 Contact _:D�-1N <br /> Transporter ' P, <br />' Address �CO Cl"' 9'633 <br /> Phone (�7� � ) - contact T-='D Z 51tR—) <br />' I hereby certify that the bove n en cked up at the generator site listed above # <br /> r <br /> Driver Signature j r <br /> Shipment Date <br /> i <br /> Truck No Load No <br /> Vehicle License No/State 4 �" <br /> ,ultant/Contractor ti—No <br /> Address P0 -2-z)lz 4=6 c C-i S 3� <br /> Phone ( � I�} �13� - ��_ _ 1 Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterizatton 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 Austin f1pad. Manteca, California 95336 e <br /> (209) 982-4298 - <br /> Received by jr 0 ` <br /> Date x A"G <br /> Acceptance No '1;�- - 1-7 LJ <br /> This load contains soil with <br /> �1 i � 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 /> RY 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 J <br /> I <br /> TRANspowrf=R COPY <br />