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' TPS Technologies Soil Recycling <br /> F ' ' Non-Hazardous Soils <br /> Date of Shipment Responsible for Payment- Transporter Truck Facility#. Given b <br /> ' Y TPS L <br /> f aad# <br /> J! ,I 2002 s✓�L�tiZl�� �� .tta� Jll' Q t� <br /> Genet+tnr s Name and Billing Address Gen — I � X <br /> entnr s Phone# Generator n US EPA ID No <br /> ' Fj ' �`1 TfU rJER itJt Person to Contxt z <br /> r (€[TE 700 F-\X# Customer Account Number r.ith TPS <br /> PHIDENIX, AZ 85004 �- <br /> COnbliltant,Name ind Billing Addri.ss Consultant a Phone tt <br /> 6102-126-0707 <br /> SLAM ENVIRONMENTAL EtY11IRONMEN AL MANAGEMENT, Ifill PeraontoContact <br /> ' r <br /> 1433 N. n11RD AVENUE BRE:t' MCDA IEL <br /> PHOENIX,AZ 8.53COI FAxl, <br /> Customer ALcount Number i,ith TPS <br /> 602-728-0708 <br /> ' 44. <br /> Gi ration Site(Tran%port fri (irnmrbaddll Site Phone# gTEX <br /> i LL VLis <br /> T U-14AUL #705-SU <br /> Person to Contact TPH <br /> 27U� N. WILSON :�i� LL,i <br /> STOCKTON, CA 95205 FAX1i <br /> AVC; <br /> CLevels <br /> VDestgnalJ Facility(Transport to) Infill t,addre,s} <br /> $F'(ilNkr'800� Factlit% Permit Numbers <br /> TPS TECHNOLOGIES, INC. �� <br /> 1232 HIBISCUS AVENUE Person to Contact <br /> 3 <br /> DELLiENA 8EIYTON <br /> `o ADEL.4NTO, CA. 92301 <br /> FAX# <br /> ,b 760-246-8004 <br /> Tr�. gr ante Ind Marling Address Trans niter s Phone# Transporter s US EPA ID No <br /> �yp�{[� (� 94 45 1-1010 (.,A0983584681 <br /> Y RI B 269 <br /> 542 TRR$BUCQ ROAD �k�0 i Person to Contact <br /> 25422 5 Trans otter s DOT No <br /> 6RTA�1 C.i4SS �5Ci647 <br /> LAKE FOREST, CA 92634 <br /> 94 y Cust10001 Number with TPS <br /> 93 <br /> Description of Sod Moisture Content Contaminated by Approx Qty Descr€pilon of De€ivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic O 0-10% ❑ Gas Q <br /> Clay 010-20%Other ❑ -o ❑ Diesel Ell ( <br /> 20%-over❑ Other ❑ I ] € <br /> -o <br /> Clay ❑ Other <br /> Sand O Organic❑ 0-10% ❑ Gas ❑ <br /> ❑ 10-20% 1:1 Diesel ❑ r (} <br /> 20°Y-over C3 tither ❑ <br /> List any exception to items luted above <br /> Generator's and/or consultant's certification I/We cel that the soil referenced herein is taken entirely from those soils described to the Soil Data <br /> Sheet completed and certi <br /> any way fled by me/us for the Generation Site shown above and nothing has been added or done to such soil that would alter it in <br /> Print or Type Name Generator 0 Consultant ❑ Signature and date Month Day Year <br /> LAR Y MOO-I #ART (BEST on behalf of GENE r91DR) <br /> Tran otter's certifica on I/We acknowledge receipt of the soil described above an cern that such soil is being delivered in exactly the same <br /> ccon itro as when r eine IMe further cert)that this soil is being directly nspor ed from th engi�atton Site ro the Designated Facility <br /> H rut out off-loa add, g to,subt cting firom r in any way delaying delivery o suchsite rr f <br /> c <br /> t a ! f Signaturea{idat - M0 Ray �eari <br /> (�fr-�f ♦ N lrj <br /> prll 1' / v <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> UPrint or Type Name Sisnatum(and date + <br /> D, RENTON! 3, PRO ANSAL f V <br /> Jill <br /> r <br /> rGsentconoTi;a r'+nav <br />