Laserfiche WebLink
t + TPS Technologies Soil Recycling s � <br /> ���8` W� ` _ 4 manifest#� <br /> Non-Hazardous Soils __0; r ` <br /> hate of Shipment Responsible for Payment 'Transporter ruck# Facility# Given by TPS Load# <br /> -17-C{6 Generatorj� a 00014 0 V <br /> Guurator s Name and Billing Addre-,ti Generator s Phone# Generator s US EPA ID No <br /> ULTRAMAR, INC. (209) 583-5545 14- <br /> 525 <br /> 525 WEST THIRD STREET Person to Contact " <br /> TERRANCE FOX <br /> HANFORD, CA 93230 USA,FAX# CastomcrAccount Numbc.rwith TP5 �« <br /> (209) 583-3282 1002367 <br /> 9 <br /> Consult-int�Nami and Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916)- 939-2170 _ <br /> 5011 GOLDEN FOOTHILL PARKWAY Persort to Contact <br /> GARY BARKER ti <br /> SUITE 7 <br /> FAX# Customer Account Number with TPS <br /> EL DORADO HILLS, CA 95762 US <br /> (916) 939-2172 4HORIZO <br /> Generation Site(Transport from) (na)m&address) Site.Phone# STEX <br /> BEACON STATION #1--641 I..evelsi <br /> 1210 EAST HAMMER LANE Person to Contact TPH <br /> Q JERRY UNRUH Levels <br /> FAX# AVG <br /> STOCKTON, CA 95210 US — Levels <br /> V 9) 5833282 <br /> Designated Facility(Transport to) (name&address) Facility Phone# Facility Permit Numbers <br /> o` TPS TECHNOLOGIES INC. (510) 235-8778 <br /> 20 RECYCLING LANE Person to Contact <br /> k Cheron RlCe/Dor Mureehilna leo <br /> a FAX# <br /> RICHMOND, CA 94801 US (510) 231-4154 <br /> t d Transporter Name and Mailing Address Transporter s Phone# Transporter's US EPA ID No <br /> ` LUTREL TRUCKING (805) 399-0246 <br /> 6315 SNOW ROAD Person to Contact Transporter s DOT No <br /> HERMAN <br /> BAKERSFIELD, CA 93308 FAX# CustomerhtVy�r�I� EberwithTPs <br /> j,,U l K�. <br /> Description of Soil Moisture Content Contaminated by Approx Oty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic❑ 0-10% ❑ Gas Q <br /> Clay Q Other ❑ <br /> 10-20%-oO <br /> ❑ tQ 7�� 3D r <br /> 20 -over Q Other <br /> Q <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ l} <br /> 20%-over❑ Other ❑ (i ; <br /> List any exception to items fisted above- ti <br /> v�. <br /> Generator's andlor consultants certification IJWe certify that the soil referenced herein is taken entirely from those soils described in the Soil Data , <br /> Sheet completed and certified by melus for the Generation Site shown above and nathing has been added or done to such soil that would alter it in e <br /> any-wayA6014- R-l?"LIPAMN! <br /> �4 <br /> Print or Type Name Generator ❑ Consultant R Sign re and date Month Day Year <br /> tC 46 It 7 914. <br /> m` Transporter s certification I/We acknowledge receipt of the soil described above and certify that such soil is being delivered in exactly the same <br /> to condition as when received IIWe further certify that this soil is being directly trans po from the Generation"Site to the Designated Facility ' k <br /> y without off-loading,adding to btrachng from or in any way delaying delive to s sit 'r <br /> IPpr,t Type Name Si re and to Mon D Y a <br /> ,�.� Q ,. <br /> Discrepancies , <br /> 1 <br /> Ir <br /> C Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> VPrint or Type Name ' Signature and date y + <br /> 1� Cheron L. RiCe/Don S. Murashima <br /> L� I <br /> �Pleaea print or type <br /> TPS INVOICING COPY <br />