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® Recycled Paper , >U� <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM E <br /> 5346 <br /> Generator A � <br /> Address <br /> Phone (709) - t/-7T- <br /> - Contact <br /> Transporter <br />' ,— <br /> Address <br /> Phone (�y) - 71 r'�n l Contact <br /> 1 <br /> I hereby certify that the oho a named material was picked up atAtxea�$nerator site listed above <br /> J vd-'`Tt <br />' Driver Signature <br /> Shipment Date <br /> Truck No - <br /> i Load No <br /> l <br /> Vehicle License No/State <br /> c,! <br /> Consuitant/Contractor <br /> � J <br /> Address <br /> Phone ( ZO5) —Contact <br /> 1 hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and ContaminatedSoil Description Form,and has been properly described,classified and packaged,and is in proper condition <br />' for transport ac ng to applicabi j gulations <br /> ` Date � -- <br /> Name <br /> Desbnatlon Forward, Inc <br />' 9999 South Austin Road~-Mca, California 95336 <br /> (209) 982-4298 <br /> Received by <br /> Date <br /> Acceptance No % 1-- - <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 /> Yards Per this Load <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />