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i' Recycled Paper <br /> ;.� tib.. � �V.i�� V� <br /> ��FO�iWARD��IN . NON-HAZARDOUS WASTE ©RIVER IDENTIFICATION FORM <br /> 4589 <br /> Generator: A & A TO L R E N T A L <br /> Address: 2911 E . FRErIONT AVE . STOCKTON CA <br /> Phone: ( 209 ) 948 - 9500 Contact: PAT [KORAN <br /> Transporter: RTCH HAMILTON TRUCKING <br /> Address: PAULItJE AVE . MODESTO CA 95351 <br /> Phone: ( 209) 578 - 4100 Contact: SCOTT MELLOR <br /> I hereby certify that the above named material was picked up at the generator site listed above. <br /> Driver Signature:`1T �` d <br /> 7" <br /> Shipment Date: <br /> Truck No.: Load No.: I Oil <br /> Vehicle License No./State: /CA <br /> Consultant/Contractor: s` ,SHF ENVIR01,.t1,Et.TA1- <br /> Address: P . O . BOX 6729 MODESTO CA 95350 <br /> Phone: ( 209 ) 579 8138 Contact: STEVE FURNAS <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, M tca, Cali rnia 95336 <br /> (209) 982.4298 l <br /> Received by: ' <br /> Date:- <br /> Acceptance <br /> ate:Acceptance No.: 92 _ 261 <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 />