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TPS Technologies Soil Recycling <br /> 1fD.leManifest Non-Hazardous Soils �' Manifest# = j.r <br /> f Shipment- Responsible for Payment Transporter Truck# Facility# Given by TPS LoadGenerator AW 37 04 00014 3tor�Na c and Billing,Address Gctierator s Phone# Gcneratnr s US EPA ID No <br /> TRAMAR INC. PcrSon to Contact <br /> 5 WEST THIRD STREET <br /> FA Customer Account Number with TPS <br /> HANFORD CA 93230 USA <br /> Consultant s Name.and Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL <br /> Pcr,on to Contact <br /> 5011 GOLDEN FOOTHILL PARKWAY GARY BARKER <br /> SUITE 7 FAX# CUStOmer Account Number with TPS <br /> EL DORADO HILLS CA 95762 USA <br /> Gun-ration Sitc(Transport from) {naim&address) Site Phonc# BTEX <br /> Levels <br /> BEACON STATION #1-641 Pe rso oltac TPH <br /> 1210 EAST HAMMER LANE Levels <br /> +� FA�PRRV UNRUH AVG <br /> yc2TnrvTnm, r A Q 110A <br /> 5159 Levels <br /> V Designated Facility(Transport to) fnanu&addre as) Fact t y hone# Facility Permit Numbers( 5110) 235-A77A <br /> 3t <br /> TPS TECHNOLOGIESNINC. <br /> Person to Contact <br /> 20 RECYCLING LANE Ch ron Ri a Don luraBhima <br /> 3 <br /> o _ <br /> �.. FAX# <br /> i r-S <br /> a <br /> Transporter Name.and Matting Address Transporter s Phone# Transporter s US EPA 1D No <br /> 4 <br /> LUTREL TRUCKING <br /> Penson to Contact Transporter s DOT No t+ <br /> 6315 SNOW ROAD <br /> pA RMAN 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 Tare Weight Net Weight <br /> Sand i❑ Organic❑ 0-1070 ❑ Gas ❑ p p 4 <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ <br /> 20%-over❑ Other ❑ <br /> Sand ❑ Organic❑ 0 10% © Gas ❑ <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel ❑ <br /> 20%-over O Other ❑ ' <br /> List any exception to dews listed above i <br /> r <br /> k <br /> s <br /> Generator's and/or consultant's certification IlWe certify that the sail referenced herein is taken entirely from those sorls described in the Soil Data <br /> Sheet completed and certified by melus for the Generation Site shown above and nothing has been added or done to such soil that would alter it in <br /> any way roeit <br /> Pint or Type Name Generator Z1Consultant ❑ Signature and date <br /> 6-001& Month Day Year <br /> A1G fl 8 16 <br /> 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 /> Ocondition as when received IlWe further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> y without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> C Pint or Type Name // /I Signature and date t Month Day Year <br /> ma 46/q` 1�, G✓, <br /> Discrepancies ' <br /> v <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above i T- <br /> UPnnt or Type Naarm/e� ! D Signature and date // t <br /> LIE <br /> V <br /> pfesse print or type i e - <br /> TPS INVOICING COPY <br />