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,� TPS Technologies Soil Recycling <br /> Manifest Non-Hazardous Soils ' 14Aar1lfeSt�#` �' ; <br /> fGenLrator <br /> Shipment Responsible for Payment Transporter Truck# Facility# Given by TPS Load# <br /> ` - Generator -� 0 00014 2 ' <br /> s Namc and Billing Addn tis Gcntrator s Phone# Gencxator s US EPA 1D No <br /> LTRAMAR, INC. (209) 583-5545 <br /> 25 WEST THIRD STREETTERRANCE FOX <br /> Person to Contact <br /> FAX# y CnStOmerACeOunt Number with TPS <br /> HANFORD, CA 93230 US (209) 583-3282 1002367 <br /> Consultant ti Nairn.and,Billing Addrtss Consnitint s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY Pcmon to Contact <br /> GARY BARKER <br /> SUITE 7 Ir FA # a9tother Adtount Number with TPS <br /> EL DO DO HILLS, CA 95762 US (916) 939-2172 4HORIZO , <br /> Gc nc,ration Site(Transport from) (na?m&address) Sitc.Phone.# BTEX <br /> Levels/./ <br /> BEACON STATION #1-641 (209) 583-3247— <br /> Person to Contact TPH <br /> 1210 EAST HAMMER LANE Leal. <br /> FAX# AVG <br /> V Levels <br /> STOCKTON CA 95210 US - <br /> VDe-agnated Facility(Transport to) (iranme&addn a) Facility Phone# Facility Permit Numbers <br /> TPS TECHNOLOGIES INC. (510) 235-8778 r4a <br /> Pemon to Contact <br /> cc 20 RECYCLING LANE Cheron Rice/Dor Murashima <br /> FAX# <br /> RICHMOND CA 94801 US (510) 231-4154 <br /> Transporter Name and Mailing Address Transporter s Phonc# Transporter s US EPA ID No <br /> ~ � LUTREL TRUCKING (805) 399-0246 " <br /> Per,�on --T r s DOT o <br /> 4�>r�,c ,x, �r,�-���-�'r-�-A 1c -. _ ,, � r <br /> HERMAN <br /> FAX# CnStOmLr Account Number with TPS <br /> BAKERSFIELD, CA 93308 4LUTREL <br /> ,K <br /> Description of Sod Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic G 0-10% ❑ Gas ❑— <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel Elf T;.0 <br /> 20%-over❑ Other ❑ (�(� <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> Clay O Other ❑ 10-20% ❑ Diesel ❑ <br /> 20%-over❑ Other ❑ r <br /> List any exception to items listed above r� <br /> w <br /> Generator's and/or consultant's certification I/We certify that the soil referenced herein is taken entirely from those soils described in the Sell Data <br /> Sheet completed and certified by me/us for tth�e Generation Site shown above and nothing has been added or done to such soil that would alter it in <br /> any way �,u �Q� L/ICI / c <br /> Pont or Type Name Generator 0 Consultant ❑ Sign and to Month Day Year <br /> czw <br /> Ic byA1F__-) 044& �t, 117 1 <br /> Tratis ot`tee's'c&t1 ca on I We acknowledge recei t o the sofl described above and certify that such soil ben lYe vered in exacta the same <br /> m P 1 g P f g y <br /> ccondition as when received IlWe further certify that this soil is being directly transported from theGe ration to the Designated Facility <br /> H without off-loading,adding to,subtracting from or in any way delaying delivery to s ch site r <br /> Pont or Type Na <br /> Signatur g Month ay ear <br /> Discrepanci <br /> U + <br /> 8[ <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above ,b <br /> i. Pont or T Name ame � Signature and date } <br /> cc <br /> cc 7/1 <br /> Plea"print or type } <br /> TPS INVOICING COPY <br />