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1 <br /> t- <br /> If5011air.. <br /> enerator: '. . <br /> ldress. 1532 aroA`dvut Sta&Jc-ft� CAl <br /> gone: (ql(e ) �` �. Contact: PA 414 C :P1 oV-01Lle - -- .- -- <br /> ,an sparter: --- <br /> d I dress: <br /> dIdress: _' G{Via, <br /> lone: i$D ) �2�' Ma Contact: f. Y r' Z <br /> iereby certify hat t Bove"named:material was picked'u tVe Ve�rator site listed above.. X141 <br /> river Signature: F <br /> lipment.Date:7 <br /> .uck No.. x. Load No.: <br /> iL1VMS <br /> hOe License Na:/S <br /> 'S <br /> ltan#1Gontractoc.,.T ' :nl v Sc V:V 1 G-S t <br /> n <br /> SS <br /> }� <br /> j6edby certify thatthe a!)ove tia a aterial is consistent with the information presented in the Waste.characterizatlo Form <br /> id'Contaminafe''So t7esc' � oI nhhas `eenpro�erly;describe� classi ie ar'i aciage d,a sm rope co clition <br /> anspb cod o a• ca ,e e• ons '� s '�"`�'�`� <br /> ame 200 <br /> Date. w <br /> astination: Forward, Inc. .' ' <br /> 9999 South Austin Road, Manteca, alifornia 95336 <br /> (209) 982-4298 1 <br /> Received by: <br /> r <br /> Date: <br /> ;ceptance No.: - - <br /> its load contains soil with: <br /> a. pp •pm r 'g°rea a' <br /> :p O <br /> [) • <br /> L _';- Y .._:::-.r.. _e _:. ._..w.'-.na-».s.e....--:w....n .:..-�...-.J»:.:#,w.—v..w»-.:..i..,vY•�.:-,...... ..:..-n.v....- w..,:xi1::. ,...J <br />