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Recycled Paper <br /> C <br /> FORWARD, INC. p NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 535E <br /> enerator AJEPA S aA S <br /> Address //.0� C f C t dk <br /> CA <br /> Phone Contact l{Wi'''t Q � A4 _ <br /> I <br /> Transporter <br /> Address 3 d <br /> IPhone (ZD� } .,�� - �� � Contact � <br /> I hereby certify that the above named material was pickedterenerator site listed above <br /> Driver Signature <br /> Shipment Date -73-7 ._171 - . 23 <br /> --- 1 .,,. ..—•-- <br /> Truck No —V1` "7,— 2 L� Load No .., . <br /> Vehicle License No/State <br /> onsultant/Contractor r20 - 10 AJ <br /> .dress CAj <br /> Phone (-zoq ) 9_57 / - _-E-30 4/ Contact A.Q <br /> II hereby certify that the above named material is consistent with the information presented in the Waste Characterization For <br /> and Contaminatedtoil Description Form,and has been p_coperly described,classified and packaged,and is in properconditic <br /> for transport ac r g to applicable r ations ' <br /> Name - Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Mca, California 95336 <br /> (209) 982-4298 <br /> Received by <br /> Date <br /> Acceptance No :27:13 - _ <br /> This load contains soil with <br /> less than 100 pprn greater than 100 pp+ <br /> ETEOPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FO <br /> AY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (208)982-4258 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 /> IWHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />