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v Recycled Paper x" T <br /> FORWAR[3a INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 47.14 <br /> Generator. E n "A L 4 <br /> 91 F FR P vT . A\? STOCKTON CFI <br /> Address: ._ .. <br /> Phone: (209 ) 948 9500 Contact: PAT D0:1?A <br /> Transporter: ' PTrH HAMTIJQP4 R U Q K " <br /> Address: 13'4 R LT ff AVE , Mt PESTC CA 95351- <br /> Phone: ( 209) 5 7 E - A1`1 --L-Contact: S60TT MELLOFi <br /> I hereby certify that the above named materia! was picked up at the generator site listed above <br /> Driver Signature: <br /> Shipment Date: <br /> 9 9c) Load No.:. <br /> 4 <br /> Truck No.: - ,. - - _ <br /> Vehicle License No./State: i�t 7 C A <br /> Consultant/Contractor: <br /> Address:_ <br /> P . n . R .k 6720 ,f00.ESTQ CA 95350 <br /> Phone: ( 209) 579 - F'13 Contact: STEVE FMRt AS . .. <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form`n. <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper condition, <br /> for transport"according to applica le regulations. " <br /> Name: Date: iv+ <br /> led <br /> Destination: Forward, Inc. <br /> 9999 South Austin Road, +• nteca, California 95336 .., <br /> (209) 982-4298 <br /> Received by: <br /> Date: <br /> Acceptance No.: 92. _ 261 <br /> This load contas oil 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'I.N 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 />