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Cl_Fir <br /> Cl_ <br /> W N Q..sa p to <br /> O Yinlrnf tu. ;■+*■a... W <br /> • ,1 j <br /> C: n A' yl`'1 � p Irl <br /> �71et No. Mp11NC- 1427 7 N <br /> M O DIYERS1FlfD 141fNERARS �l�l- N <br /> 2 �• Received,su '"� ��LADINGC) blect to she classiticatlonsand la r�32 j <br /> 0 SO u rce: DTE ' IIy filed tariffs in effect on the date nF the issue orthis Sill of lading Load <br /> C ¢ y 5ttackton LSC 2526 W.Washin on 5t. Stockton CA 95203 Cp <br /> Consi nee; <br /> Diversified Minerals Inc, IT1l Odity. DYES Fl Ash <br /> 1100 Mountain View Ave. Oxnard CA <br /> estinativn: Holloway Environmental solutions LLC. 805 247-1069 <br /> Delivery <br /> �71Address: 13850 Hollow- !toad Lost Hills CA 93249 O <br /> 0 Delivering r-• C <br /> � Carrie': ❑DMI Transportation � <br /> 0 1 ❑ Other -• <br /> Source; (Non-Hazardous Material Manifest) <br /> f 2 Carrier: (To Be Filled In By DTE} <br /> ❑TES Stockton,LLC Truck It <br /> � � GROSS <br /> Address: 2526 W,Washington Se, Truck Lis p <br /> City/Stote/77p: Stockton,C,4 95203 Phone:(209]3217-3722 �� ARE <br /> -+ Trailer# LTJ Y� HET <br /> This is to Certify that the DTFS Fly Ash(ram biomass combusd0n is o nun- Trailer(s)LDc►� 3,��, TONS <br /> 0 hozardaus material when us Or beneficial use in occordonce as de ned in arm'Fly Ash is properly parka ,marked,labeledartd+n proper condition for <br /> u nia Wost f tren5portatian acmrding to the applicable regularrans of the Department of <br /> � 01 & e Code 5ecdon 25143.5 Section(f) Tmns,aprtanbn and the FAA.SDS are available upon request. <br /> ' 20 123- x <br /> 593 Autharixed Signature ate& ime Lo-ded <br /> oyy AuthorizedSignoture bar &Tim Shipped <br /> 3 Liahili Statement; 5ubfecttocanditiansa f <br /> applicable ro Coll-11110 low and this bih of lading,this shipment is to be delivered to the destmantion only without <br /> recourse on theS0urce,Consignee and Destination.Delivery vehicle is designed farpublicroad mtidirr-ns.Request 6y Aestinatien farmaterial placement in area not <br /> W S so desiigned relieves Source and Consignee.prapasition E5:This product is known in the State of cadfrnia to cause cancer.Additional safety is ihtedon SDS <br /> O 4 Notes: <br /> ::T!7 <br /> ati <br /> Al �,yC <br /> yy° I B41 of Lading is to remain in 4 parts until time of shipment. <br /> xx <br /> t Receiving Signature Date Faceived <br /> tom,c <br /> Whrte:(DTEStockton LLC) Canary:(Desh'notion) Pink"(0mi) Goldenrod:{Transporter] <br /> WS Ticket# <br /> n Trip Ticket 555555557 <br /> o Product FLY ASH <br /> p <br /> Load# STKTN-13245 Species BULK <br /> 0 <br /> cNh Gross 38.37 76,740 Date In 10/27120 12:28:11 Scalei5caler 4142 DENNIS pQLIN.1R <br /> Gross 15.05 30,100 Date Out 10127/20 12:213:11 <br /> W Net 23.32 46540 <br /> Sample Type: BULK <br /> WEIGHMASTERCERTIFlCATE Requested tests: cQ o <br /> O THIS IS TO CERTIFY that the foil owing described commodity was weighed,measured,0 counted by a Wei gIaster.whose�$Ctrtll R M C) <br /> Ge rtific ate,who is a recognized autho rlty of accuracy,as pies Cd bed by Chapter 7(c ammencln t? <br /> tC'r1 ausiness and Professions Code,administered by the Division of Measurement Standards of the Cal orniaop p l e t 01vision p� li3prtyl� <br /> rs (DRIVER OFF SCALE) (I <br /> �I cod and Agriculture. _ <br /> N p <br /> � Cn <br /> Driver: <br /> N <br /> (D <br /> N C I - 00 <br /> O <br /> i <br /> 009 <br /> N � <br />