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T <br /> PS Technoibgies Soil Retycri <br /> } Manifest ` <br /> f q Non-HazaiCdous Soils JT Date of Shipment Aesponstble for L'aymentTransporter Truck# Faality# Given by TPS Generator LSA -. 5 14k A04 00014encrator s Namc and Btllmg AddrewsGenerator s Phonc# Gent-ritor s US E.PA ID No <br /> ULTRAMAR, INC. (209) 583-5545525 WEST THIRD STREET Peru,ntoContactTERRANCE FOX <br /> FAX# Customer Account Number wi <br /> HANFORD, CA 93230 USA (209) 583-3282 1002367 <br /> Consultant s Name.and Billing Addicss . Consultants Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2570 <br /> 5011 GOLDEN FOOTHILL PARKWAY PcrsonWConA <br /> GARY BARKER �y <br /> SUITE 7 CnStOme C Account Number with TPS <br /> FAX# <br /> EL DORADO HILLS, CA 95762 USA (916) 939-2172 4HORIZO <br /> Gene rihon SAL(Transport tram) (naini &address) Site Phone# BTEX <br /> sk <br /> Levels <br /> BEACON STATION #1-641 <br /> PcrPon to Contact T1 R <br /> 1210 EAST HAMMER LAKE JERRY UNRUH Levels # s <br /> +W FAX# AVG ; <br /> STOCKTON, CA 95210 USA - Levels � <br /> C Designated Facility(Transport to) (nanir&addnss) Facility Phone# Facility Permit Numbers <br /> v ( 510) 235-8778 <br /> `o TPS TECHNOLOGIES INC. <br /> Person to Contact <br /> 20 RECYCLING LANE C. Rice/D. Muraeh ma <br /> E `RICHMOND, CA 94801 USA 1550) 235-4154 <br /> V. transporter Name and Matting Address Transporter's Phone# Transporter s US EPA ID No � <br /> "LUTREL TRUCKING (805) 399-0246 <br /> fa355 SNOW ROAD Person to Contact Transporter s DOT No <br /> HERMAN <br /> FAX# Cus4oE5+rkc�ygt Number with TPS <br /> $AKERSFIELD, CA 93308 4L, GL <br /> Description of Sod Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand ❑ Organic❑ 0 10% ❑ Gas ❑ <br /> -o Other <br /> l0- ❑ ❑ <br /> Clay ❑ other ❑ <br /> 2090-over❑ Other ❑ <br /> 0-IO�o ❑ Gas ❑ i. <br /> Sand ❑ Organic❑ 70-20% ❑ Diesel ❑ <br /> �Y ❑ '� ❑ 20%-over❑ Other ❑ R <br /> List any ve hon to items luted above <br /> v <br /> Generatorly and for consultant's certification If We certify that the soil referenced herein is taken entirely from those soils described in the Soil Data 5 <br /> Sheet completed and certified 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 nt� L <br /> or Type Name Generator ❑ Consultant ❑ Signa d date- Month Day Year <br /> &4a.lcj�a y t <br /> Trans-porter's certification I/We acknowledge receipt of the soil described abov and certify that such soil is being delivered in exactly the same w <br /> condition as when received IfWe further certify that this sod is being directly transported from the Generation Site to the Designated Facility ; <br /> h withou off-loading,adding to,subtracting from or in any way delaying debve o uch site <br /> W Pn <br /> Name <br /> f f Signat ate Motes Day Year <br /> h <br /> 0wrepancies 3+ <br /> k r <br /> S L <br /> GRecychn�rPacilrty certifies the receipt the soil covered by this manifest except as noted above <br /> L1 <br /> Print Name Si to an ate <br /> � i <br /> ° 44=4tj I- <br /> R <br /> Please print or tjq* <br /> TPS INVOICING COPY <br />