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Recycled Paper <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br />� a 53ss <br /> Generator - - C�!2 u)-4 5 •} • - - - <br />' Address .c' 1 1Cr 4,)1-- 7T0r'jeT4 AJ, ,.0-A .,. <br /> Phone Contact 2=A1& Cd'[Z&�'4 _ <br /> 1 <br /> Transporter K f <br />' Address <br /> Phone (21: } �� 9 �-, 1 *ontact .L'I _ <br />' I hereby certify that the above named material was picked up at the oDerator site listed above <br /> 3, <br /> Driver Signature <br /> — <br />' Shipment Date 3— Z — 9.3 ...._ <br /> Truck No i�,]j i TLoad No <br /> Vehicle License No/State 2L1 <br /> Consultant/Contractor A —0—C [ 15=L L]e T/6 <br /> Address Z <br /> r 1 <br /> Phone ( zp�) �51 _ ����- � -- Contact r <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contaminated So)l Description Form,and has been properly described,classified and packaged,and is in propercondition <br /> for transport according to applicable regut tions <br /> Name _ __ L - -- -- rf � .-._ -�=-• ' Z ` 9 3 <br /> � - .� Date <br /> Destination Forward, Inc <br /> I 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 }' <br /> Received by <br /> Date - <br /> Acceptance No <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 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 ''C 2 14. � ;k <br /> F - WHITE-FACZLITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />