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I BARD, INC. NODI-HAZARDOUS WASTE DRIDER xDENTIFICATIONFORM <br /> or: Time Time Oil Co. <br /> T,lddress: 1.3475 N. Jack Tone Road <br /> e.- ( 206) 285_- 2400 <br /> - 1contact: Anastasia E. Duarte <br /> Transporter:_ T j <br /> :Address: ru kin Inc. <br /> Phone: { 916 )_381 ram n to CR 9582$ --- <br /> �$§��; Contact: Mr. Tim Mahle f <br /> I hereby certify that the above named material was picked up at the <br /> generator site listed above. <br /> ^r Driver Signatur = } <br /> r Shipment Date: <br /> - - . Truck No. : G <br /> Load No. <br /> Vehicle License No. /State: 6 <br /> Consultant/Contractor Canonie Environmental <br /> Address <br /> Phone: 415 463 - tXa1QO. Pleasanton, CA <br /> { }_ — 9117 ;Contact: David Poole <br /> ` I hereby certify that the above named material is consistent <br /> with <br /> ` the information presented in the Waste Characterization Form :�and <br /> i <br /> Contaminated Soil Description Form, and has been properly <br /> v described, classified and packaged, and is in proper condition for {fl <br /> transport according to applicable regulations. i <br /> Name: ;1 ;�-- ;; " Y,. ,r}, .�, ,J- ,1 � <br /> �� 1 Date: March 27 1992 <br /> Destination: Forward, Inc: <br /> 9999 South Austin Road, Manteca, California 9533'6 t3 <br /> (209) 982-4298 <br /> Received by: 1; <br /> Date: € <br /> Acceptance No. : 92 -- 174 1 <br /> - -- — 1s <br /> f <br /> This load contains soil- with: <br /> _XXXXXX_ less than 100' ppm greater than 100 ppm <br /> I <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST.'' BEf' <br /> SUBMITTED AT THE GATE FOR : ENTRY. ALL LOADS MUST BE SCHEDULED 'AT <br /> LEAST 24 HOURS IN ADVANCE: (209) 982-4298 LANDFILL DELIVERIES MUST <br /> BE SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY <br /> REFUSED AT THE GATE. <br /> Yards Per this Load: 18 Cubic Yards <br /> — I <br />