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Recycled Paper <br /> 4� v Iftwe <br /> LFORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 4711 <br /> Generator: A & A TOOL RENTAL <br /> Address: 2911 E . FREMONT AVE . STOCKTQFr , CA <br /> Phone: ( 209) 948 - 9500 Contact: PAT DQkAN <br /> Transporter: RICH HAMILTON IBUCKING <br /> Address: - - _. 13aa-_PAULTNI AVE . MODESTO . CA 95353 - <br /> Phone: ( 2 0 9) 578 - 4100 Contact: S CUT M E L L O 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.: � > _ _ Load No.: 11 <br /> Vehicle License No./State:, � /CA -- --.__-- _ <br /> 3 . <br /> i - <br /> Consultant/Contractor: 1^114F ENVIRONMENTAL - - <br /> Address: P . O . BOX 6729 MODEST0 CA 95350 <br /> Phone: ( 2092 578 - 6138 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. / G <br /> Name. Date: J S <br /> Destination:.Forward, Inc. <br /> 9999 South Austin Road, Ma , California 95336 .-1 <br /> (209) 982-4298 - <br /> Received by: <br /> Date: r i 3 <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 YFLI-OW-TRANSPORTER COPY PINK-GENERATOR COPY <br />