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�. <br /> 7 WT <br /> Imp"'ienerator: <br /> address: 2 ��� D rr� <br /> 'hone: (q(p) 3� O� . .� Contact: Y __.f` �.� _ _ 0 YiQ <br /> 'ransporter: e r V i <br /> 'hone: (S() Contact: r <br /> hereby certify tha he above name aterial was picked up at the generator site listed above: <br /> )r'iver..Signature'. <br /> ,hipmeRt Date: ' <br /> tNes <br /> ruck.No.: Laad No.: <br /> —_ <br /> � <br /> 'ehicie License No.IState. <br /> ! . <br /> Itant/Contractor: <br /> 'hone: 2 4" ori#act 4 <br /> hereby certify thattheat�ove named ma*er�8 s consistentwith the information presented in the Waste Characteriza.ia Farrr. <br /> fir:,• ,. - �;�;>-� � ,� :;•. .� +�;. <br /> nd Contaminated s6iibes yip io or n' s ee roe oesc ibex classified an; ackaged,and is-i AfiJ grope co clition <br /> � tra,spa di,g. <br /> r <br /> Ilkw <br /> lame. Date. „ T <br /> 3 <br /> - <br /> )estination: Forward, Inc. <br /> 9999 South Austin Road, Man eca, Califor is 95336 <br /> (209) 982-4298 '-'-.• <br /> Received by: <br /> Date: ' <br /> ,cceptance No.: - <br /> 'his load contains soil with: <br /> Z1.UO t _� x gre to tha 00 P <br /> ® g f. Ep p <br /> tw DS <br />