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TPS Technologies Soil Recycling <br /> ;. Manifest r Non-Hazardous Soils Manifest y <br /> + .Y Date f Ship writ Responsible for Payment Transporter Tru f# Facility# Given by TFS Load# <br /> Generator1 A 04 00014 5 <br /> Gene rtor,N c and Billing Adilrc.Ns Ge critor�Phone# Gc.ncrator s US EPA ID No s' <br /> ULTRAMAR, INC. (209) 563-5545 <br /> Pei�tintoContaet e. <br /> 525 WEST THIRD STREET <br /> TERRANCE FOX <br /> FAX# Cri5tOnlLrAccount Numbcr with I PS <br /> HANFORD, CA 93230 USA (209) 583-3282 1002367 <br /> Consult-int s Nacnc urd Billing Address Consniont s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 d <br /> 5011 GOLDEN FOOTHILL PARKWAY Fuson to Contact <br /> GARY BARKER <br /> SUITE 7 FAX# Customer Account Number with TPS <br /> EL DORADO HILLS, CA 95762 USA (916) 939-2172 4HORIZO <br /> Gencr3hon Sitc (Transport trom) (name&address) SAL Phone# STEX <br /> Levels <br /> 3947 <br /> BEACON STATION *1-641 - <br /> Person to Contact TPH <br /> .. <br /> 3.210 EAST HAMMER LANE levels <br /> MFAX# AVG aka <br /> y STOCKTON CA 95210 USA levels <br /> c <br /> VDesignated Facility (Transport to) (came&address) Facility Phonc# Facility Pcrmrt Numbers <br /> o TPS TECHNOLOGIES INC. (510) 235-8778 <br /> Person to Contact <br /> 20 RECYCLING LANE Cheron R3.ce/Dan Muraolaima <br /> p FAX# .y <br /> W RICHMOND, CA 94801 USA (510) 231-4154 <br /> Transporter Namc.and Marling Address Transporter s Phone# Transporter s US EPA ID No <br /> LUTREL TRUCKING (805) 399-0246 <br /> 6315 SNOW ROAD Person to Contact Transporter s DOI No <br /> HERMAN <br /> FAX# Customer Account Numb with TPS <br /> BAKERSFIELD, qA 933084 4LUTREL <br /> Description of Soil Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand Cl Organic❑ 0-10% ❑ Gas ❑ 'r � <br /> Clay ❑ Other O 10-20% ❑ Diesel ❑ <br /> 20%-over❑ Other ❑ <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> 10-20% ❑ Diesel ❑ �f <br /> Clay ❑ Other U 201/6-over❑ Other ❑ <br /> ]rst any exception to Zeins listed above <br /> a <br /> Generator's andlor consultants certification 1lWe certify that the soil referenced herein is taken entirely from those soils described in the Soil Data <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 6 (A L M <br /> Print or T pe Name Generator ❑ Consultant ❑ Signa and d t Month Day Year <br /> 1 - �� b fo <br /> Transporter s certification IlWe acknowlfdge receipt of the soil described above and cert that such soil is being delivered in exactly the same r <br /> ocondition as when received IlWe further certify that this soil is being directly transported fro fr`thr Generation Site to the Designated Facility <br /> y without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> Print o Type Name signatu and ate Month Day Year } <br /> � v <br /> 0 (� <br /> Dis epanats <br /> r' <br /> C} <br /> Recycling Facilrty cerfifies the receipt of the soil covered by this manifest except as noted above <br /> Print or Type Name Signature and date <br /> V � � <br /> L • <br /> Please print or type <br /> TPS INVOICING COPY <br />