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PS Technologies Soil Recycli r <br /> b [i fQSt ` �1',Aan1fest# ; <br /> Non-Hazardous Soils <br /> +rt <br /> PI).teShip t Imp �re�f �y_mentTransporter Tru # Fac�l�Yv# G�ypNa TWs <br /> ItU_ lu7BB i aLMG : r t Pi R4�$ tU1GUlenerrator s US EPA ID NoA 7 d a ddre�, T A 9.95-5545 <br /> 525 WEST THHIRD STREET PLrson to Contact <br /> TERRANCE FOX <br /> Cu o o NumbcrwithTPs <br /> HANFORD, CA 93230 USA <br /> F�Y09) 583-3282 ������� <br /> Con,ult int,Name and Billin Addmss Consultant-;Phone# <br /> HORIZON ENV19ONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY PdiM1C'VXhKER <br /> SUITE 7 <br /> FAX# Cus Number with TI'S <br /> EL DORADO HILLS, CA 95762 USA (916) 939-2172 (04192b <br /> Gcncrahon Sltl(Transport from) (narnL&address) Site Phone# 7L--vels <br /> BEACON STATION #1-641 (209) 583-3247 1210 EAST HAMMER LAN£ - Personto ContactJIE:RRY UNRUH FAX# <br /> ' STOCKTON`, CA 95210 USA (209) 583-3282 Levels <br /> c <br /> D T)t.signated Facility(Transport to) {dame t�addre�s) Facilit Phone# Facility Permit Numbers <br /> TPS TECHNOLOGIES INC. <br /> v ( s�0) 235-8778 � <br /> `o <br /> ,fon t�CoCta�ct/D. MurBeh ma <br /> 20 RECYCLING LANE 1 <br /> O FAX# ` <br /> RICHMOND, CA 94801 USA (510) 231-4154 ; <br /> T'ransportcx Name and Mallin Address Trans B�Se)s 399-0246 <br /> Phone# Transporter s U5 F1'A 1D Na <br /> LUTREL TRUCKING (a � <br /> 6315 SNOW ROAD Pcrson to C011taLt Transporter s DOT No <br /> HERMAN <br /> FAX# Cu ltimtt Number with TPS <br /> BAKERSFIELD, CA 93308 t <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 /> 10-20% ❑ Diesel ❑ <br /> Clay ❑ Other o 20%-over❑ Other ❑ <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> 10-20% ❑ Diesel ❑ <br /> Clay ❑ Other ❑ 20%-over Q Other ❑ . <br /> List any exception�ofteins listed above e a h ' + ♦ + d i 7 y <br /> Generator's andlor consultant's certification Il We certify that the soil referenced herein is taken entirely from those soils described in the Soil Data <br /> Sheet completed and certified by mews for the Generation Site shown above and nothing has been added or done to such soil that would alter it in <br /> any way I/L U'I' <br /> Pant or Type Name Generator ❑ Consultant Q Signa a Month Day Year <br /> t� <br /> `m Transporter's certification IIWe acknowledge receipt of the soil described a and cern such soil is being delivered in exactly the same <br /> t <br /> t condition as when received Il We further certify that this soil is bei ectly transported from the Generation Site to the Designated Facility <br /> Hwithout off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> P Type Name S date Month Day Year ` <br /> O <br /> Q4screpanaes r <br /> L <br /> Recycling Facility certifies the receipt of the soil covered by,his manifest except as noted above <br /> Signatu and ate <br /> P or Type Name <br /> 4 l <br /> � V L., J <br /> phase print or type <br /> TPS INVOICIN OPY <br />