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FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 00448 <br /> Generator: ��` —rTLK <br /> Address: <br /> Phone: (2GQ} `"QHS - contact: <br /> Transporter: ��p r�� A� <br /> Address: <br /> Phone: ( Contact: <br /> I hereby certify tht the Bove named material was picked up at the generator site listed above. <br /> -? <br /> Driver Signature;` �' `0Y- <br /> Shipment Date: <br /> Truck No.: 7'-) ::? Load No.: # <br /> Vehicle License No./State: <br /> Consultant/Contractor: rz fir <br /> Address: <br /> Phone: (0\ � ) � - — Contact: <br /> I hereby certify that the above named material is 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 regulations. <br /> Name: Date: <br /> Destination: Forward, Inc. <br /> 9999 South Austin Road, anteca, Califo nia 9536 , <br /> (209) 982-4298 <br /> Received by: -�' <br /> Date: <br /> Acceptance No.: <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 SCIJJEQ,JLED ON ,A DAIM.DASIS. ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE. <br /> Yards Per this Load: <br /> RECEIVES <br /> TRANSPORTFR COPY <br />