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" Recycled Paper <br /> FORWARD, INC, NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> t 5370 <br /> Generator A20 /4 <br /> AddressL— <br /> Phone twC ) _ - _5 '1 _Contact C"EPA <br /> Transporter 4POe j�_ w c_z_ <br /> Address <br /> � 1 <br /> Phone g,LS,.. Contact <br /> II hereby certify that the above named material was picked up AAhi generator site listed above <br /> Driver Signature <br /> Shipment Date <br /> Truck No Load No <br /> IVehicle License No/State <br /> Consultant/Contractor <br /> Address 7 N/AJb 411 <br /> Phone �'5-1 - 9 32 ey —Contact a!� D kJ b <br /> I <br /> I hereby certify that the above named material is consistent with the Information presented in the Waste Characterization Form <br /> and Contaminate oil Description Form,and has been properly described,classified and packaged,and is in propercondition <br /> I for transport ac c g to applicable requdations <br /> r r <br /> Name Date Z -- <br /> I <br /> Destination Forward, Inc <br /> 9999 South AusttaAaed, Mfenteca, California 95336 <br /> (209) 982-429$ <br /> Received by <br /> Date <br /> 7`2 <br /> Acceptance No 3 350 r� <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 /> IYards Per this Load 1 I <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />