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$OHL SAME NO eA— G PS H - rf{-�•-'s �tit. a -+,j lona 4� tl i C. i LY >� "f •}t�ilY� � t _ E r�y $�.�,}'If.S�+ I�Fe�� ,�y t F ,, 4 � t ��"�� i e i}ti�k Non-Hazardous Soils Date of Shipment: itesponeible for Payment: Transport ruck N. Facility 0: Approval Nquibter:/� Generators Neme and Biting Addrees: Generator's Phorie i8413�4Q0-8200 CAD081406792 ;l T�ELEVEN,INC'. 5ti if r Person to Contagt: P.O.BOX 80741 aa; u, r lx RANCHO SANTA MARGARITA cA oases " �_ FAX1F. Customer Account Number �a ' Consultant's Name acid Billing Address: Consultaid's Phone#: t r �= kg rti Person to Contact: L �+•;) FAM Customer Account Number r �: 't"1 Generation Site(lkanepoit hom):(riame&address) Site Phone#: to fi209-463-1259 . u 7-ELEVEN 14117 , 4 Person to Contact: 2726 COUNTigY CLUB BLVD- a STOCKTON,CA 96204 FAX#: �q $ �. 1 k; U Designated Facility(Transport to):(name 6 nddmss) Facility Phone#: SOIL SAS=E Person to Contact: ` 12$28 HIBISCUS JOE �FOVAN9AL . , k o ADE,LANTO,CA-02301 FAX#: 4, (780)246•-8004. 'hanspoi 4r Name and MaltinifAddress: Transporter's Phone#: 849-460-6200 GAROOb 18381 BEL5HIRE.. . ,. l 2607'(TOME CENTRE DRIVE Person to contact ` FIPOTHiLL"RANCH,CA 82410 LARRY MOpTHART 4600 go FAX#: Customer Account Number BESI:24.7049 g1�9-et60.5210 , 1. Description of.Soil Moisture Content. Cgnlaintnated by: Approx.Qty: Description of_Delivery' Gross-Weight Tare Weight Net Weight 0-10% 13 Gas ❑ + Sand E3 organic❑ .. , 10 -o ElOtE) Clay❑ Other ❑ � „.�• �.��,� r : 20%-over .❑ Otherher 131 � Sand❑ Or anic❑ 0-10%- El Gas E3N g 10-20% ❑ Diesel ❑ Clay❑ Other ❑ 20%-over' ❑ Other ❑ • `��M 8+ List any exception to items listed above: Scale Ticket# Zn Generator's rind/or consultant's certification:I/We certify that the Boil referenced herein is taken entit'ely from those soils descried in the Soil Data s Sheet completed and certifued by me/us for the Generation Site.shown above and nothing lois been added or done to such soil that would alter it in any way. Z2 a, "L` PrintorTypeName: , Generator ClConsultant ❑ Signatureiu a Month• Da Ye ^L, LaMU Mag1hart.6f 8F,91 _ ��' L Transporter's certification:l/We acknowledge receipt of the soil referenced above and certift that such soil is being delivered in exactly the same '0 condition as when received:I/Ve/)trther certify that the soil is behjg directly transported fro Generation Site to the Designated Facilitij y without off-loading,adding to,subtrr' fing from or in anyway delaying del:'very to such sit i Int or Type Name: Signature and date: Month Da' Year 1 11 �fKAM t. :t ` U „-a e, �4 11 Discrepagcies d. I Recycling Facility certifies the receipt of the so covered by this manifest except as noted above: Print or Type Name Signature and date: 1=S 13 J.faROVANSAL r u-.,r.;'yl. +.Y �=hFg�d�}y j�4rtdcl�,�im�fSf S+"!�}t'y{,'L(Jit �y) tJ i�;p��11''{y�'til� y�;�i`.14 �j ,�1 .t1 t{�tA Asn!# t�S}'tv5•': ;(}��1�Q.��?n,�• {4lY.�yT'y�.�.'�yt�n �'��,�itta``a{�,`�<<`l i'��F.�c3�1,ty,a 't:��. d<an4vra'��,+Is„'h�''`1�t�y1i�.<`�t 6�:'irz•�...��:_5.5�5(. TRANSPORTER COPY .............................._..._.... _... '' ...... .