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Recycled Paper <br /> FOJAWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5144 <br />'6 Generator EP A �R�A� 14 <br /> Address �Z a CI r L- tJ <br />' Phone (�) <br /> �,/7 _ Contact AOZ� AA—j <br /> tTransporter k-f: <br /> Address �AJ <br />' Phone (fig) �°�' _ a ,, contact <br /> I hereby certify that the abbe name ma nal was picked up at the generator site lisTed above <br /> tDriver Signature L&� ``�� <br /> Shipment Date <br /> Truck No <br /> 11 P I- a1— Load No <br /> �n <br /> Vehicle License No/State `� L �f <br /> nsultant/Contractor f <br /> (2o,�JSTi2 J G7"`/0 �cJ <br /> 10ddress . 7 S H/nJ C' <br /> Phone (�C1rj) - - --Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Fon <br /> and ContaminatedS&I Description Form,and has been properly described,classified and packaged,and is in proper conditic <br /> for transportong to applic b e-re gulations-- <br /> ( Date — � <br /> Name <br /> L <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 �--_ <br /> Received by <br /> Rata <br /> Acceptance No - —3�! <br /> This load contains soil with <br /> less than 100 ppm greater than 100 ppr <br /> OPY OF ?-N1S SHEET <br /> MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOi <br /> ,*TRY 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 />