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1 <br /> ,enerator: <br /> ddress: �' <br /> hone: ( (0 } - Contact: _ a J7.fG _ .10 ltiS � <br /> ransporter: Y V 1 CL-f� i <br /> ddress: 1 Cwt t <br /> hone: {g j Q _Contact: r <br /> iereby certify that the abovana edmaterial wa picked up at the generator site listed above. <br /> river Signature: <br /> iipment Date: i <br /> -uck No.: Load No.: - <br /> 9hicle License No./State: <br /> , y <br /> Itant/Contractor: Ste�'� �� V • � ✓I 0115 <br /> Jdress: Mark �_ <br /> lone: ( �j S} - 9� _Contact: j.5 <br /> iereby certify that the above named material inconsistent with the information presented in the Waste Charactenza�io Forrn <br /> id Contaminated Soil Description Form,and has been properly described,class fled andpackaged,and is i p.rop'�e ca�dition <br /> r transport acc 1 to aapplicable,'regulations. <br /> ame: w Date ti:,t <br /> r <br /> estimation: Forward, Inc. <br /> 9999 South Austin Road, Manteca, Ca ifornia 9533 <br /> (209) 982-4298 <br /> Received by: <br /> Date: <br /> ;ceptance No.: -At4 - •�2 -- <br /> its load contains soil with: <br /> Iess than 100 ppm fi y e <br /> saw, <br /> YE��� �' <br /> US G�HEDU D • i S N SG+� ED • <br /> � s ,I <br />