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Sep 08 03 04: 41p 949-589-7910 p- 2 <br /> TPS Technologies Soil Recycling <br /> Non-Hazardous Soxis n I <br /> Y Taalsl 3F Given by TPS Load 4 <br /> Date of Shipment Responsible for Payment Trrnesparfer Truck y1 i <br /> ConstAlt Zil1t A07 20983 <br />' ('tmritor S Name and Qdbng Address <br /> Generator s Phnnc lr dent nlgr s US EPA ID Nt> y <br /> PPiC I F i C BELL_ <br /> PO BOX 5095 RM 3 E 0000person to Contact t <br /> FAX# Customer Acrnunt Number weth Tl'S <br /> SAN RAMON, CA 94583 USA 7PACBSR <br /> Consultant s Name znd Btlhng Address Consultant's Phone tt <br /> F_XCELL EXCAVATING, INC. t i 1y , 249--22Z5 <br /> P. O. BOX 617E llkrson to Comite! <br /> MARK TEMPLET014 <br /> FAX# Customr r Account Number tis eth T <br /> 1—AGUNA N I GUEL, CA 92607-6176 USA t7141 249-6265 1001-1428 <br /> 5iti,Phone# aTGX <br /> C.LVILT ttpn Site(Trinspurt frc)rn} {"vane&address) heti ck <br /> SB+C/P t-lC BELL — TRAC I —EXCL2 � <br /> Pt.rtioti to Contti't TPFl <br /> Uk Cita <br /> AVC ' <br /> FAXlt <br /> Levo ls <br /> TRACY, CFS 00000 <br /> USA <br /> 4 Tinli Ptwnc# FacilttvPtrnutNumbcas <br /> 17eaihnated faetlit}(Transport tot Meant, £+redrfrrs+t t8ti1Q1 B62-800 1 <br /> TPS TECHNOLOGIES <br /> Person to Contact <br /> c DELLENA JEFFREY ` <br /> la 12328 HIBISCUS <br /> o FAXit - <br /> ADELANTO. CA 9a301 USA ( 760)246--8004 <br /> Trans <br /> m rise s US EPA ID Nc, <br /> 1 ransf urtLr Name,rad M 1111r`64ddrr�s FrTnsporter s Phone It iaO x� <br /> M1 t7 ^.r <br /> Person to Contact- Transporter s DOT No0 60 14 (900 lis <br /> ` `A-- FAXp Cuslomt.r Account Number with TP4 ..! <br /> x '1 J ' <br /> DescnpNon of Soil Moisture COnW Contaminated by ApprOX Qty Description of 0e11very Gross Weight Tare Weight Net Weight F= <br /> Sand U Ory,,inic 4Gas <br /> O 1D% ❑ Diesel R � ray <br /> 10 2036 ca <br /> Clay Ij Other -j -aver : <br /> 20% Q Other ❑ i <br /> Sand O Organic P D-IM ❑ Gas O h <br /> 10-2D4t. ❑ Utesel ❑ <br /> ct,,y ❑ Other ❑ 20%-over❑ Other O mf <br /> Ltst any exception to items tasted atmos' -} <br /> x <br /> " Generators a►td/or consultants certification I/We certify that the soil referenced herrn is taken entirely fram those soils described in the Sot!Data <br /> Sheet completed and cerhfied by me/us for the Generation Site shourn above and nothing s been added or done to such soil that would alter it in <br /> any tvay <br /> th aav Year <br /> Print or Type Nntne erator (;prtsultant Signature And date � <br /> `t JAW e <br /> Xr Transporter s cert�catran (/We acknowledge receipt of the sort described above and certify that such soil is bang delirrered in exactly the same <br /> ri`; a condition as when receiied I/We further certify that this soil is being directly transported from the Genera hon Site to the Desrgrtated Facility <br /> y without off-loading adding to,subtracting from or in any way delaying delivery to such sites <br /> Mantis L7nY Yea. <br /> T'ri or Ty Van! 5�grwmne and dale !�I 0 N <br /> 3r � V <br /> 1 repAn[ies. <br /> CS k' <br /> Recyclutg Facility ccrhfies the receipt of the soil covered by this manifest except as note above- <br /> Print <br /> ve. <br /> Zx <br /> Print m Type Name Signature and date <br /> i7. JEFFREY/J. PROVANISAL/R. DAEPR <br /> ' 09/08/D3 MON 15 45 [TX/RX NO 56481 01 002 <br />