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® Recycled Peper <br /> FORWARD, INC. <br /> ' NON—HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5351 <br /> i <br />' Generator <br /> Address <br /> Phone (Zc7`�) �� — _ _ 5-,5--/!s7. Contact <br /> Ar k r <br /> Transporter <br /> Address X <br /> Phone Contact ' <br /> i !L <br /> I hereby certify that;th,!v�,e ate was,pick d up as�l generator site listed above <br /> Driver Signature ' <br /> iShipment Date <br /> Truck No 2 Z Load No <br /> Vehicle License No /State <br /> Consultant/Contractor r <br /> Address <br /> Phone (z6rj) -2 L - 9 '?O _Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contaminated Sor5pescription Form,and has been properly described,classified and packaged,and is in proper condition <br />' for transport accord�+3g to applicable regal ns <br /> Date <br /> Name <br /> Destination Forward, Inc <br />' 9999 South Austin Road, eca, California 95336 <br /> (209) 982-4298 <br /> Received by -, <br /> Date <br /> - - — <br /> Acceptance No :,::� <br /> ' This toad contains soli 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 _ C <br /> WHIM-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />