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fin <br /> ' PS Technologies Soil Recycli <br /> Non-Hazardous Soils <br /> ' Date of Ship5ent: Responsible for Payment: 4Transporter Truck#: Facility Given by TPS: Load# <br /> - O I Cori SI-1 22646 <br /> "7 - a0 '7 <br /> Na�,a��.Bil]ino AWfr ;L INC. Generator's Phone#: Generator's US EPA ID No. <br /> YK th' fC l.F< -Kt14 1 <br /> ' 3600 NW 82ND. AVE. <br /> Peolr�o CpnY1 N DOUGLAS - <br /> tjIAMI, FL 33166 USA FAX#. Customer Acc Qj berwith TPS <br /> 7Occ l x <br /> Consultant's Name and BilhnAddress: Consultant's Phone#: ti. <br /> FREY ENVIRONMENTAL (949) 723-1645 <br /> ' <br /> 2817 A LAFAYETTE AVE. <br /> Person to Contact: <br /> EVAN PRIVETT <br /> FAX#: Customer Account Number with TPS: <br /> Gf4E*ik{r?®8Mrar4U4Tn"}6ubvAen1&a*6.'". USA Site(I}tioA€zl) '/+_�—i$J<i BTEX10006521 <br /> RYDER LC1071 — FREY1 Levels <br /> Person to Contact: IPA <br /> ' m 3633 DUCK. CREEK, DRIVE Levels <br /> z FAX#: AVG. <br /> r STOCKTON, CA 00000 USA Levels <br /> ' U Designated Facility(Transport to): btarae£address) <br /> Facility Phone#: Facility Permit Numbers <br /> a TPS TECHNOLOGIES (800) 662-8001 <br /> C Person to Contact: <br /> 0123228 HIBISCUS DELLE'NA JEFFREY <br /> ' _ FAX#: <br /> m ADELANTQ, CA 92301 USA (760) 2 6-8004 <br /> Transporter Nanie and Mailing Address: Transporter's Phone#: Transporter's US BPA ID No.: <br /> ' B. E. S. I. (949) 460-5200 CAD983584681 <br /> 25422 TRABUCQ RD. 41215-26,g Person to Contact Transporter's D07 No.: <br /> LARRY NOOTHART 4;;0647 <br /> ' EL TORO, CA 9',? FAX#. Customer Account Number with TPS <br /> 530 : <br /> USCI 9�9i 461Zi—Sc1P 7013019,3 <br /> Description of Soil Moisture Content Contaminated by: Approx.Qty: Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> ' Clay ❑ Other ❑ 10-20% ❑ Diesel <br /> 20°/-over❑ Other <br /> Sand ❑ Organic❑ 0-10% ❑ Gas O <br /> Clay ❑ Other ❑ 10-20.% ❑ Diesel ❑ <br /> ' 20%-over❑ Other ❑ I <br /> List any exception to items listed above: <br /> Generator's and/or consultant's certification: IlWe cert that the soil referenced herein is taken entirely from those soils described in the Soil Data 1 <br /> ' Sheet completed and certified by me/us for the Generation Site shown above and no Ing has been added or done to such soil that would alter it in <br /> any way, l <br /> x- tint or Type Name ' - <br /> )Pamr [onsultant ❑ Signature and daMonth Day Year <br /> ' 1 06 17 <br /> Transporter's certification: l/We acknowledge receipt of the soil described above and cert that such soil is being delivered in exactly the same <br /> o` condition as when received. 1/We further cert that this soil is being directly transported from the Generation Site to the Designated Facility <br /> �¢ without off-loading,adding to,subtracting from or in any way delaying delivery to such site. ' <br /> Print or type Name: � d <br /> i <br /> J\ <br /> ro v� i� 1' © Signature and darn: ,/'1� � yj Month Day l;ar <br /> t I f( I �y V <br /> 411 Discrepancies: �/ � <br /> ' v <br /> ' U / <br /> l <br /> - 5 Recycling Facility certifies the receipt of the sail cowered by this manifest except as noted above: <br /> U <br /> fifi U <br /> Print nr <br /> m D yN Name: gand day�JEFFREY FlVANSAL \ / <br /> TDC Ihl\/rllr�l Air] r`IIDV <br />