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P525t TPS Technologies Soil Recycling <br /> inlfesfi � Non-Hazazdous Soilsp ent J Responsible for Payment Transporter Truck# Faci4ty R Given by TPS Load tYt�cjo Generator 3 ? F_ 0 00014 0 <br /> Namc and Bslluig AddressGenerator s Phone# Generator s US EPA Ip No <br /> TRAMAR, INC. (209) 583-5545 <br /> WEST THIRD STREET Person to Contact " <br /> TERRANCE FOX i <br /> FAX# <br /> HANFORD, CA 93230 US CustamcrAccountNumbcr with TIS �t <br /> (209) 583-3282 1®02367 L <br /> Conaultint s Name and Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939--2170 <br /> 501.1 GOLDEN FOOTHILL PARKWAY Pcr,,ontoContact <br /> SUITE 7 GARY BARKER <br /> EL DORADO HILLS, CA 95762 USAFAX# Customer Account Number with TPS �R <br /> (916) 939-2172 4HORIZO <br /> Generation Site(Transport from) (nami E+address) Site Phone# BTEX , �' <br /> ' <br /> BEACON STATION #1-6411 (209) 583-3247 Levels <br /> dx 1210 EAST HAMMER LANE Person to Contact TPH � <br /> JERRY UNRUH Levels ' <br /> CAVGFAX# <br /> STOCKTON, CA 95210 US (209) 583-3282 Levels <br /> V Designated Facility(Transport to) (name&addreNs) Facility Phone# Facility Permit Numbers <br /> TPS TECHNOLOGIES INC. (510) 235-8778 <br /> �c 20 RECYCLING LANE Person to Contact <br /> Cheron Rice/Dorl Muraaehima <br /> 114 <br /> FAX# <br /> —RICHMOND, CA 94801 US (510) 231-4154 <br /> Transporter Name and Mailing Address Transporter's Phone# Transporter s US EPA!D No <br /> LUTREL TRUCKING (805) 399-0246 <br /> 6315 SNOW ROAD Person to Contact Transporters 1](7T No <br /> HERMAN <br /> BAKERSFIELD, CA 93308 # Customer4,9cjgy�giberwith TPS F" <br /> Description of Soli Moisture Content Contaminated by Approx Qty Description of Delivery Gross WeighhtU Tare Wlelght Net Weight W <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> Clay ❑ Other ❑ 10-20%-o ❑ LheseOther ❑ do�Q 2-1/t n A—� � <br /> 20%-over❑ Other ❑ , C7J O TV <br /> Sand ❑ Organic❑ 0-10% a Gas ❑ w <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ L�1 <br /> 20%-over Ll Other ❑ r s <br /> Wt any exception to items fisted above } <br /> 1 yF <br /> Generator's and/or consultants certification IIWe certify that the soil referenced herein is taken entirely from those soils described in the Soil Data <br /> Sheet completed and certified by mews for the Generation Site shown above and nothing has been added or done to such soil that would alter it in <br /> � anyway r <br /> Print or Type Name Generator ❑ Consuliant ❑ Signature and date <br /> Month " <br /> ay Year t <br /> /7 g f <br /> cL_ Transporter's certification Il We acknowledge receipt of the soil described above and cer ify that such soil is being delivered in exactly the same <br /> condition as when received Il We further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> W) without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> Printor T Name S= tune and date <br /> I'll, <br /> � Month Day Year <br /> 061 <br /> Discrepancies <br /> C Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> Print or Type Name Signature and date <br /> t� Cheron L. Rice/Don Murashima � <br /> it <br /> �Ploaw pr!r t or type <br /> TPS INVOICING COPY <br />