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d Recycled Piper a - <br /> �� <br /> FORWARD; INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 47.09... <br /> Generator: <br /> Address: 2911 F-- FRFNQNI A'VF .- STOCKTON CA -- --- .:_ <br /> Phone: { 209 ) 9 8 _. 9500 -. Contact: P AI DORAU r <br /> Transporter.: RICH HAMITOPI TkICKING - <br /> Address: 1336 M.19DEST0 C'A 95351 <br /> Phone: { 209 ) 578 - 4100 Contact: 5COTT EMLLOR <br /> I hereby certify that the above named?�natefi�l was picked up at the generator site listed above. <br /> Driver Signature: - 4 <br /> Shipment Date: <br /> Truck No.: -"i'S cJ _- - —.—.Load'No.: Clu <br /> Vehicle License No./State: rLs JCA <br /> ConsuItan t/Contractor: ' WHF 'FNV1R01`,IMEP!TAL <br /> Address: P :•0 . BOX 6729 MODESTO CA 95350 <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 /> Name: . / Date: <br /> Destination: Forward, Inc. <br /> 9999.South Austin Road, Maet;a,Californ'aJ95336 <br /> (209) 982-4298 . <br /> Received by: - -- <br /> Acceptance No.: .92 _ 261 <br /> This load contains soil with: , <br /> less than 100 ppm greater than 100 ppm <br /> - <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE -LOAD,-AND MUST BE SUBMITTED AT THE GATE FOR <br /> ENTRY.ALL LOADS MUST BESCHEDULED AT LEAST 24-HOURS>IN ADVANCE: (209}982-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS. ANY-UNSCHEDULED'LOADS MAY REFUSED AT.THE GATE, <br /> J <br /> Yards Per this Load:..._ ` , <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER'COPY' PINK-GENERATOR COPY <br />