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Recycled Paper <br /> G d <br /> IF <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION ::R� <br />■■ � 5354 <br /> Generator <br /> CID 4 _)'2 4,J ;4 <br /> IAddressf!.-y� <br /> Phone (�2) _?L_5L - _SS S Contact U <br /> 46 <br /> Transporter <br /> Address <br /> Phone 209) 411 '7 9/6 5 Contact & <br /> 1 - <br /> I hereby certify that the above <br /> ve faired material prcked up atahbogenerator site listed above <br /> Driver Signature - <br /> Shipment Date 2 <br /> Truck NoLoad No 2 1 <br /> Vehicle License No/State ::j/zr <br /> Consultant/Contractor <br /> Address G3-7 <br /> Phone (ZC.9) 9r-r - _ 5' 3©_C_'/_ _Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper condition <br /> for transport according t applicable regul Iz:is <br /> _ 2 <br /> Name Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Man , California 95336 <br /> (209) 982-4298 ` <br /> Received by <br /> Date <br /> Acceptance No <br /> This load contains soli with <br /> less than 700 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 _ Z `J - <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />