Laserfiche WebLink
W. <br /> Ps '[echnololgidt-Soil Recycli <br /> �a. r�' .• Tion-Ha2"us 5oi)s <br /> Date of (J Rmpotia@le fur Payment' TranaporOts Truck t F.WtyF -flisit�TPS`*•;: <br /> ;' Of <br /> Ti!'plarator A04 00602 0p7 <br /> Genera 's Name aid Billing Addicts: Generator's Phone k Generator's US EPA ID No. <br /> Arco Pro Co. (925) 299-88'91 <br /> *i <br /> P. O. Box '5077 Person to Contact <br /> Paul Supple <br /> FAXth. Customer Account Number K-nth T[',. <br /> Buena. Park# CA 90622 USA (925) 299-8872 1002332 <br /> Consultanfs Name and Billing Address: ^ Consultant's Phone k. _ <br /> Senor (650) 691-0137 <br /> 1225 Pear Avenue Person to Conact <br /> Robert Potter <br /> FAX#: Customer Account Number with TPS: <br /> Mountain View, CA 00000 USA (650) 691-9837 4SECOR9 <br /> Generation Site(Transport from):.(mare&address) Site Phone#: BTEX <br /> ARCO 1'04493 levels <br /> Person to Contact TPH <br /> � 205 NortA .Center Street hr is <br /> r <br /> - FAXN: AVC. <br /> G - USA levels <br /> VDesignated Fadlity(Transportto): (..&add.) Facility Phone#: Facility Permit Numbers <br /> TPS TECHNOLOGIES INC. 510-235-8778 <br /> so 2�Recyciinq 'Lane Personto Contact <br /> Debra Tucheen <br /> `o <br /> �. FAXp: - <br /> � 'Richmondr i 9480.1 USA 510-231-4154 <br /> 01 Transporter Name and Mailing Address: Transporter's Phone#: Transporter's US EPA ID No.: <br /> Dillard Environmental (925) 634-6850 <br /> P. O. Box 579 Person to Contact: Transporter's DOT No.: <br /> Reagan Cortez <br /> FAX#: Customer Account Number with TPS: <br /> Byron, CA_-�94514 USA (925) 634-0569 1002780 <br /> Description of Sol( MoistureContent Contaminated by: Approx.0ty:1 Description of Delivery Gross Weight TareWeight Net Wek,1d <br /> Sam Organic 0-10as <br /> 1 clay � Ono' C396 C1 GC!30-20% Duel ❑ <br /> 20%-over O Other ❑ <br /> Sand o Orgaldc❑ 0-10% ❑ Gas ❑ <br /> Gay ❑ Other o 10-20% ❑ Diesel ❑ <br /> 20%-ova❑ Other ❑ <br /> Ian any eaorption m ihw Bated above: <br /> Generator's and/or consultant's cglification: 1/11e certify that the soil referenced herein is taken entirely from those soil 'bed in the Soil Dad <br /> Sheet completed and certifted 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 /> any way. <br /> Print or Type Name: Gmaaror O Co..Wtant O Sgnanue and date: Month Day Year. <br /> Transporters certification: We acknowledge receipt of the soil described above and certify that'such soil is being delivered in exactly the same <br /> condition as when received. 1/We further certify that this soil is 'ng irectly rted from the ation Site to the Designated Facility <br /> qwithout off-loading,adding to,subtracting from or in any way dela g I' such site. <br /> Pilt% � tore ddate: MonthDa Y <br /> Dtwepareies: <br /> tL / <br /> tT <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above: <br /> V Print,nT Name: <br /> YPe Si�turt and Bate: 4. <br /> . <br /> 2 1 <br /> TRANSPORTFRS muv <br />