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1:... <br /> - I <br /> I <br /> enerator: <br /> ddress: ) 532 <br /> 373 _ _4043 _ Contact: 1 le" kVVV <br /> Otter M I/1 <br /> dress: !ez <br /> none Contact: <br /> zereby certify that the ab v arced m enal was picked up at the generator site listed above. <br /> river Signature: <br /> r.s: <br /> pment Date: <br /> Load No_: <br /> uck No.: <br /> cie License No•/State: ` <br /> �ltant/Contractor -r- r V,(_-es � <br /> :Ik <br /> r = yrs S,k . 2 t. <br /> ress r = <br /> Contact. Yt,�ft V[A/i/1 <br /> �e�by cQrtffy tha eabove named mat consistent with the information presented ire:he Waste Charactenza4io or <br /> . .<..W.,,a r• <br /> Co taminateti oil Descrip ion For ,gaas been properly described,classifiied and packaged,and is i Aper con ition NO <br /> able gLAI <br /> ons <br /> ' C� <br /> ame - <br /> Oate: <br /> estination: Forward, Inc. <br /> 9999 South AustinRoad, Mante a, Californi 95336 <br /> (209) 982-4298 r. ^ <br /> Received by: ' <br /> Date: <br /> ;ceptance No.: - - j <br /> its load contains soil with: <br /> ;� �-.:��� '��: .,:; ;.r:: , - • Iess�than.1.00p m <br /> •O :R ST OAD, g g :p <br /> . <br /> E I S <br /> 1 <br />