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" Recycled Paper ' <br /> FbRWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5381 <br /> Generator: / " E�i F' J r. i ry <br /> Address: % /c <br /> Phone: o q ) 2// I� Contact: S S <br /> Transporter: ✓uI �', 1 <br /> Address: <br /> Phone: ( j,o q ) _ - f''C �, Contact: <br /> I.hereby certify that the above named aterial was picked up at the generator site fisted above. <br /> j <br /> Driver Signature: <br /> Shipment Date: <br /> Truck No.: f �" Load No.: <br /> Vehicle License No./State: s <br /> Consultant/Contractor: <br /> Address: S' _ 7(« <br /> Phone: ( 20 Contact: G� �,= .j .. .,.._....�_ <br /> i v <br /> I hereby certify that4he above named materiakis consistent with the information presented in the Waste Characterization Form <br /> and Contaminated Soil Description Form,and'has been properly described,classified and packaged,and is in proper condition <br /> for transport according to applicable reguiatibns. <br /> Name: /, =�� Date: <br /> _ I <br /> Destination: Forward, Inc. i <br /> 9999 South Austin Road;Manteda,'California 95336 <br /> (209) 982-4298 r <br /> Received by: <br /> Date: <br /> Acceptance No.: ` � �� . _ C <br /> This load contains soil with: <br /> less than 100 ppm greater than 100 ppm <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> ENTRY.ALL LOADS MUST BE SCHEDULED'AT LEAST 24 HOURS IN ADVANCE: (209)982-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS: ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br /> Yards Per this Load: <br /> WHITE-FACILITY COPY ' YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />