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l <br /> \TPS Technologies Soil Recycling <br /> -Manifest Non- <br /> Hazardous Soils h` { <br /> fG(nt <br /> Shipment- Responsible for Ilayment Transportertrutic# Facility# Given by TPS Load# <br /> Generator 3 y --a� 0 00014 2 <br /> r s Name and Billing Address Gcnerator s PhonL# GenLrator s US FPA ID No <br /> LTRAMAR, INC. (209) 583-5545 <br /> 25 WEST THIRD STREET Pcrson to Contact <br /> TERRANCE FO <br /> PAX# Customcr AcLomit Numbet with TI'S <br /> HANFORD, CA 93230 US (209) 583-3282 1002367 r <br /> Consultant,Name and Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 ` <br /> 5011 GOLDEN FOOTHILL PARKWAY Person to Contact <br /> SUITE 7 GARY BARKER <br /> x <br /> FAX# Customer Account Numbcr with TPS <br /> EL DORADO HALLS, CA 95762 US (916) 939-2172 4HORIZO <br /> GLnLration Sitc(Transport from) (narnL&address) Site PhonL# BTEX <br /> , BEACON STATION #1-641 - <br /> Levels <br /> 1210 EAST HAMMER LANE Person to Contact LPH 3947— <br /> JERRY UNRUH �`e� <br /> ti FAX# AVG <br /> STOCKTON, CA 95210 US _ Leveis <br /> C7 DLsignated Facility(Transport to) frtame&address) Facility Phone# Facility Permit Numbers r� <br /> `a TPS TECHNOLOGIES INC. (510) 235 -8778 y y; <br /> 20 RECYCLING LANE Person to Contact <br /> Cheron Rice/Dar Murashima <br /> FAX# <br /> RICHMOND, CA 94801 US (510) 231-4154 <br /> Transporter Name and Matting AddrLss 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 /> FAX# Customer Account Number with TI'S - <br /> BAKERSFIELD, CA 93306 4LUTREL <br /> Description of Soil Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic❑ 0-10% ❑ Gas Cid <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ <br /> 20%-over Q Other ❑ �J <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ <br /> 20%-over Q Other Q <br /> Lust any exception to items listed above <br /> Generator's and/or consultant's certification Il We certify that the soil referenced herein is taken entirely from those soils described in the Soil Data > <br /> Sheet complete�d//and <br /> ,,,4&�certified by melus for the Generation Site shown above and nothing has been added or done to such sod that would alter it in� <br /> any way !� FU *ip F— <br /> Pnnt or Type Name Generator ❑ Consultant ❑ Sigr al and date ,lam Month Day Year <br /> G!O(/�tJfV y C�G <br /> L Transporter's certification IIWe acknowledge receipt of the soil described above and certify that such soil is being delivered in exactly the same s <br /> ocondition as when received IIWe further certify that this soil is being directly transported from the Generation Site to)he Designated Facility <br /> I without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> .j <br /> Pont or Type Name Sign�reand ateMonth Day Year <br /> I <br /> L7iscrepannes z <br /> Z <br /> '1r� ff r xw <br /> C Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> boPrint or Type Name Signature and date i <br /> "Please print or type V <br /> TPS INVOICING COPY <br />