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TPS Technologies Soil Recycling <br /> ` <br /> Manifest Non-Hazardous Soils 4, Manifest#i 4, , <br /> TDaj,1Shipment Responsible for Payment Transporter Truck# Facility# Given by TPS Load# <br /> Generator 3 04 00014 3 <br /> or s N im,and billing,Addrvsti Gcncritor s Phonc li Generator s US FPA 1D No <br /> TRAMAR INC. (209) S83- <br /> 1'r rson to Contact <br /> 525 WEST THIRD STREET <br /> FA #6RRANGE FOX Customer Account Numbcr with TPS <br /> HANFORD CA 93230 USA <br /> Comultant 5 Nano ind Billing Addles Consultant s Phone# <br /> HORIZON ENVIRONMENTAL <br /> 5011 GOLDEN FOOTHILL PARKWAY Peron to Contact <br /> GARY ARKER <br /> SUITE 7 FAX# Customer Account Number with TPS <br /> EL DORADO HILLS CA 95762 USA <br /> Gc ncration Site(Transport mom) (nayne &address) Site Phone# BTCX <br /> Levels <br /> BEACON STATION #1-641 pA�?WgZt.-,P83-3247 TpH <br /> 1210 EAST HAMMER LANE ERRY__ Levels UNRUHT <br /> S FA AVG tt <br /> HLevels + <br /> C <br /> VDetiignatcd Facility(Transport to) (name&addrt,�) F,aci i i e# Facility Permit Numbers <br /> a <br /> TPS TECHNOLOGIES INC. person to Contact - Y . <br /> 20 RECYCLING LANE <br /> Q FAX# <br /> �1 t <br /> Transporter Name an Mailing Address Transporter s Phone# Tran�portcr s U; A ID No <br /> LUTREL TRUCKING' �. <br /> Person to Contact Tran porter s o <br /> 6315 SNOW ROAD <br /> FA Customer Account Number with TPS <br /> BAKERSFIELD CA 93308 4LUTREL'�- <br /> Description of Soil Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Torre Weight Net Weight <br /> Sand Other 0 10% ❑ Gas ❑ lS� <br /> Claya � 'e❑0 0-20% ❑ Diesel p <br /> t0%-over❑ Other ❑ <br /> Sand ❑ Organic❑ <br /> 10% ❑ Gas ❑ t <br /> Clay ❑ Other ❑ <br /> W-20%o ❑ Diesel ❑ <br /> - <br /> 20%-over CI Other ❑ n y <br /> List any ex[Ceptron to items listed above 'w e <br /> srs' <br /> Generator's and/or consultant's certification IIWe certify that the soil referenced herein is to tirely from those soils described to#flee�oil Data � <br /> Sheet completed and certi edby elus for the Generation Site shown above and nothing has Reen added or done to sugh soil that would alter it to f <br /> anyway !A1 <br /> F <br /> Pint or Type Name Generator ❑ Consultant ❑ Signa and date Month Day Year <br /> FWr <br /> Transporters certification IIWe acknowledge receipt of the soil described above and certify that such soil is being delivered in exactly the same <br /> ocondition as when received IIWe further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> y without o -loading,adding to,subtracting from or to any way delaying deliveo uch site <br /> Print ype Name Signat da M th t7ay Y <br /> i� <br /> +ti's <br /> panties <br /> 1 <br /> V , <br /> tL , <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> Pint o/rJTy�pe�Name Signature and date, <br /> Mase print or type <br /> «! J J 1Y <br /> TPS INVOICING COPY <br />