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�,,M- 7 <br /> • l .: : <br /> 'NOf 002 t ► '� - 1 IDENTIFICATION F� <br /> 03 <br /> enerator: <br /> Jdress: 2 W S+VC --VY) 001 ' <br /> lone: (611 (e) - — - 0e3' contact: 00 Gid 1 O <br /> x <br /> i <br /> •ansporter:. !'Vi <br /> r _ <br /> Jdress: r <br /> lone: (goo- 1722 - _ 0-7 -11 - Contact: <br /> iereby certify that the above n med mat rial s picked up at the generator sk a listed above. <br /> river Signature:. <br /> iipment Date: - <br /> -uck No.: Load No.: <br /> chicle License No.%State: 9� / - <br /> tant/Contractor: f <br /> �- SCV vGtS- <br /> s tt,c.ba, E- <br /> Contact: <br /> ,ereby certify that the above named material is consistent with the information presented in the Waste Characterization Fona <br /> id Contaminated Soi " escription Form,and has been properly described,classified and packaged,and is in propercondition <br /> rspo'` a con o°applicable regulations. 1 <br /> Mme: <br /> Date: •�� L ._ <br /> sstination: Forward, Inc. <br /> 9999 South Austin Road,Mkanteca, California 95336 <br /> (209) 982-4298 <br /> Received by: <br /> Date: 7r r 2 <br /> :ceptance No.: .�- - <br /> eis load contains soil with: <br /> less than 100 ppm greater than OO,ppm '., <br /> EET ST�ACCOMRANY EV RY ASTE O D, AN MUST BE SUBMITTED A T7 E•GA AOR <br /> SCWD' ULED T' E S 1=10lJRSlN�l�fJV '` C ' x(209 '9$O 98=`'�ANDF L..D 'LI ERI S - <br /> S SCS © I - AS • .ANSC =D L �D LO B r EFUSED AG ' <br /> ti <br />