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Recycled Paper <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 4704 <br /> Generator: R & A TOOL TENTAL <br /> Address: 2911 E F EP I 'T AVE STOCEITON , CA <br /> Phone: ( 209) 948 _ 9500 Contact: RAT DEAN <br /> Transporter: BICH HALjTI TON_.T.f3Li(-K T l•I r; T <br /> Address:_ 1 2qC, PAlll TUE AVE - mnOFSj0 ,,CA--- 95351 <br /> Phone: ( 209 ) _ 5Z8 - _ 41nn Contact: SCOTT MELLO R <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.: i� _ II CC Load No.: 05 <br /> Vehicle License No./State: r,�ir�_> rX /CA <br /> Consultant/Contractor: IdMF I O an F I <br /> Address: P . O . ROX ro R M QST A 9,5350 <br /> Phone: ( 209 ) 579 - 8138 Contact: STEVE FURNAS <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 /> a <br /> Name: ti° 2 , Date: <br /> Destination: Forward, Inc. <br /> 9999 South Austin RoadMa'hteca, California 95336 <br /> (209) 982-4298 <br /> Received by: 4`� <br /> Date: _ �✓ 7_j <br /> Acceptance No.: 92 _ 261 <br /> This load contains soil with: <br /> less than 100 ppm .greater than 100 ppm <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> ENTRY.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 /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />