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IS Recycled Paper <br /> i � e <br /> FFORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> f 5349 <br /> Generator <br /> i Address <br /> Phone ( z -�1 _ 7 _ / Contact per' <br /> Transporter _ G <br /> iT <br /> Address � � <br /> Phone (ZD 5) � _ --g�f^ —Contact <br /> "' / U <br /> I hereby certify that the above ria ed material d uRaytRe generator site listed above <br /> Driver Signature <br /> Shipment Date -'— <br /> Truck No Load No <br /> Vehicle License No/State <br /> 17 <br /> Consultant/Contractor <br /> Address - � <br /> Phone (ZO,9, ) 45'� — - 9�� —Contact <br />' <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Forr <br /> and Contaminated Soil-Nescription Form,and has been properly described,classified and packaged,and is in proper conditiot <br /> for transport accordlf applicable re tions , <br /> Date <br /> Name <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Mant a ifornl 95336 <br /> (209) 982-4298 <br /> Received by <br /> —Daatte� <br /> Acceptance No _L_! - <br /> This load contains soil with <br /> less than 100 ppm greater than 100 ppr <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WAST: LOAD, AND MUST BE SUBMITTED AT THE GATE FOI <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 /> --4f- <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />