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M 1 T� <br /> ® Recycled Paper � <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5348 <br /> Generator OA <br /> Address - <br /> Phone Qe)q ) --�— - Sl 57 Contact '9 <br /> Transporter L <br /> s <br /> Address <br /> Phone 7-C) - Contact <br /> tI hereby certify that the above named aterlal was picked up aZ V00!generator site listed above <br />' <br /> Driver Signature c� <br /> Shipment Date 3 r 2- /' <br /> Truck No ;)— Load No — �� <br /> 7Q /L �1 �� <br /> Vehicle License No/state <br /> Consultant/Contractor T `1 0� <br /> -L3 2 <br /> Address —� � <br /> Phone (zQF) _s___� - � Contact -- <br /> I hereby certify that the apove named material is consistent with the information presented in the Waste Characterization Forn <br /> and Contaminated Sofrescrlptlon Form,and has been properly described,classified and packaged,and is In proper conditlor <br /> Iq <br /> for transport acca gto applicable reg <br /> uiatjons �^ <br /> Date - <br /> Name <br /> 1 <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Ma ca, Callfo Ia 95335 <br /> (209) 982-4298 / <br /> Received by <br /> Date <br /> Acceptance No 7E - <br /> This Load contains soil with <br /> less than 100 ppm greater than 100 ppn <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOf <br /> ENTRY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIE' <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 />