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I! <br /> SOIL SAFE OF CA - TPST <br /> y� r n lYl�ttl� l•�•+r ` } <br /> h •:� ,,:'r �������.�`v;.'. :.r'' � <br /> Non-Hazardous Soils <br /> Date of Shipment ltesponelble for Payment transport Trac #: Facility S: Approv!!M r, r/ `f s` <br /> (�If/ <br /> I! Hca A07 <br /> '' Generatnes Name and Billing Address: Generators Phone#: 'P. <br /> t34S6 46i?-52DQ CALOOG225724 : <br /> Sr WEST COAST PRODUCTS, Ll Fermi to Contact: <br /> O.O. BOX 80248 <br /> RANCHO SANTA MARGARITA,CA 92488 FAX#: Customer Account Number <br /> Consultants Name ni�nd Billing'Addre6s Consultants Phone#: <br /> t4r <br /> Person to Cnrxtact <br /> PAX#: Customer Account Number <br /> Q. z <br /> Generation Site('iYanspo i from):(name&address) Site Pliune 8: <br /> BP 02180 �r5 <br /> Person to Contact 5° <br /> 3212 N.CALIFORNIA. 01 <br /> STOCKTON, CA 96204 PAX#: sA <br /> J."... N <br /> ` Ur` <br /> Designated Facility(15ransport to):(name&addrrsa) Facility Phone#: <br /> R <br /> ;z c 890 <br /> SOIL SAFE <br /> Person to Contact <br /> rt: 12328 HIBISCUS AVENUE= e <br /> DELLENA JEFFREY <br /> Q ADf LANTO t:A 52301 <br /> FAX#: <br /> 780 2410-9004 <br /> Transputer Name end Mailing Ae3dreas: Transporters Phone 6: <br /> ;. <br /> 848-4611-6200 CA D00183013 <br /> BELSHIRE <br /> �}• RPerean to Contact v <br /> -Y 25$79 T01NME CENTRE DRIVE LARRY MOOTHART 4501147 <br /> FOOTHILL. RANCH, CA 87810 .w <br /> PAX#. Customer Account Number kg <br /> BESI: 207972 84480-fi210 <br /> }2, <br /> Oeseripdon of Soil MolsWre Content Contaminated by: Approx.Qty: Descriptlon of Delivery Gross Weight Tare Weight Net Weight ' <br /> Sand❑ Organic❑ 0-10% © Gas ❑ c�?� �}�j -7 -s° <br /> r <br /> Clay❑ 2 . olQter ❑ 20% a0er 0 other <br /> jS <br /> a-1;0% 4 Gas Q <br /> r Sand C] organic❑ - <br /> r�x 10-20.� ❑ Diesel p _ <br /> Clay O Other Q F - 209E-aver' ❑ purer ❑ <br /> ;7. List any exception to items listed above: Scale Ticket# x <br /> 1. Generator's anr�/or consultant's certification:I/INe certify that the soil referenced herein is taken entirely from those soils descried in tate Soil Data ik, <br /> - Sheet"pleted and certified by m4lus for the Gerieratioh Site shomn above and nothing has."a ed or done to such soil that would alter it <br /> YR. in any way. <br /> `. Prmt or Type Na3rre: Generator ❑ Consultant ❑ Slgnature and date: Month Day Y <br /> laK» <br /> Transporter's certification:I/We acknowledge receipt of the soil referenced above and certify that such soil is being delivered ; exactly the same ? <br /> condition as when'received.-I/We further grtff that the soil is being directly transported from the Generation Site'to the Designated Facili ? i <br /> ^, without off-loading,adding to,subtracting froth.or in any way delaying delivery to such site. t <br /> rt Po/FJfypp Nnnger Signature art te: --—-- - M Da oar <br /> Discrepancies: (. ) <br /> P. k <br /> tom ' <br /> = Recycling Facility certifies the receipt of the soil covereif by this manifest except as noted above: r <br /> Paint or Type Name. Sigeat:ura and deter <br /> rw. <br /> a D. JEFFREY/J. PROVANSAL_ r ` <br /> ��1 ML�n'����4p�1{1{�; <br /> TRANSPORTER COPY <br />