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�1 <br /> x x: m;- <br /> ,AT ` V <br /> 3nerator: ` <br /> idress: <br /> gone: ij( Contact: G# -/( �; -7 VV <br /> Yl <br /> ansporter: e r I rQ <br /> q 2� 40-71 Contact:. t r <br /> lone: (Sps) _ <br /> Beeby certify that the'. bove named material was picked up at the generator site listed alcove. <br /> -fiver Signature: <br /> +ipment Date: <br /> � — <br /> ucic No. ..��_ Load No.: . <br /> :hicle' License No./State:?Z)1 3 - <br /> tarit/Contractor G ilV JG v ✓! <br /> ` f fLT[ <br /> i ess ,,. . , ., <br /> Rorie ( f } Contact: a <br /> e!I certify that the ibo ve named material is consistent with the information presented in the Waste Characterization Form <br /> d Contaminated S iI Descri.tion Form,and has been properly described,-classified and packaged;and is in proper condition <br /> s ort acr o appa e�tregulations; <br /> Date: <br /> .17 X'Skw- <br /> tstination: Forward, Inc. <br /> 9999 South Austin Road, Manteca, alifornia 95336 <br /> (209) 982-4298 • <br /> Received by: <br /> Date: <br /> :ceptance No.: - a2- <br /> -is <br /> 2•is load contains soil with: <br /> rl. seater tha- "pm <br /> r•. Y r' - less.,than°1fl0 p m '� <br /> S •• * M AN_: R A.;. D M S TIED AT G O <br /> k :S C -• LE 209 S - 8$ AND L 5 <br /> = S SC 1=D DNIM A�V-LROP AU' <br />