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FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 0522 <br /> t <br /> Generator: <br /> Address: .5S- c,o <br /> Phone: - S-oao Contact: <br /> Transporter: c'w- `a c{�` `"` <br /> Address: S_ = s�� k tca -. c`T �-. Ct-. 2 v__z -- <br /> Phone: (hoc, <f Contact: GcQr c5 <br /> 1 hereby certify that the ve named material was picked up at the <br /> generator site listed above. <br /> Driver Signature: �A <br /> Shipment C4 �- <br /> Truck No.: 30 (4 Load No.: <br /> Vehicle License No./State: <br /> Consultant/Contractor: L2 <br /> Address: <br /> Phone: ( CEr6 ) _.... <br /> Ci - G�� Contact: l ''^ <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: L-4- Date: r 4A <br /> Destination: Forward, Inc. <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by: <br /> Date: <br /> Acceptance No.: 12- - / <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)982-4296 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 /> RECENE15 t'`ik"" I J 19:"2 <br /> TRANSPORTER_COPY. — — — <br />