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- - Recycled Paper } <br /> ` IDENTIFICATION FARM <br /> [IFORWA�RDING' NON-HAZARDOUS WASTE DRIVER <br /> 515 <br /> 14 <br /> Generator A) P 5 <br /> Address <br /> 417 g _ 55-1 contact <br /> Phone <br /> Transporters L)C'kCC� <br /> Address <br /> Phone (?� ) <br /> Frritact <br /> I hereby certify that the above named material was picked up at�the generator site listed above <br /> Driver Signature <br /> 3 <br /> Shipment Date 3 3 r <br /> Load No <br /> Truck No " <br /> SZ� <br /> � 1 <br /> Vehicle License No/State <br /> lRnsultant/Contractor �l r A)G <br /> ddress . - 37 S <br /> Phone (?fig') <br /> 9T 3o Contact '�•�� o����� <br /> I hereby certify that thaabove named material is consistent with the information presented in the Waste Characterization For <br /> and ContaminatedZ Description Form,and has been properly described,classified and packaged,and is in proper conditic <br />' for transport actor o applicable,re ulations <br /> Date <br /> Name <br /> Destination Forward, Inc 1 <br /> ' 9999 South Austin Road, Manteca, California 95336 <br /> y (209) 982-42981 <br /> Received by <br /> Date <br /> Acceptance No 7 93 - 3 <br /> This load contains soil with <br /> f less than 100 ppm greater than 100 ppi <br /> r ,OPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FC <br /> ALL l~OADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DEI_IVERIE <br /> t. -TRY <br /> Ml(ST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yar�er this Uoad <br /> �r'�l ,,�' iTE.�jgTY COPY YELLAW-TRANSPORTER COPY PINK-GElu1ERATOR COPY <br />