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® Recycled Paper <br /> e � <br /> WARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5362 <br /> Generatorr_P u1,454 <br /> V !r <br /> - Address 32 <br /> hone (Zjo� ) 4/79 - SSS/ _ - — Contact r <br /> I � <br /> Transporter � ' K E <br /> Address _ <br /> Phone (Z 0, ) - 9�f� Contact - IPA ,!I._.. ---- - -- <br /> I hereby certify that the a ove named material was picked rip&8)&8) g rator site listed above <br /> I Driver Signature <br /> Shipment Date ` <br /> Truck No �T _: -- - Load No <br /> Vehicle License No/State _ �1� 22� Com- _--.--- <br /> Consultant/Contractor �} o gj C-7-10 AJ CO <br /> Address PC---e.5 A)G ��_ : >74C <TV c) <br /> Phone Qp5? e_1Contact <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 applicabtle regulations, <br /> f <br /> r. r�L�2.w� rr !� � <br /> Name �.c .�' .r _ - _ Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road teca�California 95338 <br /> (209) 982-4298 <br /> Received by <br /> 47 <br /> Date ---....,. <br />! Acceptance No <br /> This load contains soil with <br /> fff 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 /> I 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 />