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TPS Technologies Soil Recycling manifest <br /> y so Manifest Non-Hazardous Soils - <br /> Date of Shipment Res tinsible for Payment Transporter Truck# Facility# Given by TPS Load# �?r <br /> 5 <br /> �eneretoyr 7�f/D � 377 04 00014 <br /> GcMritr'�Min(and Billing Addres§ Gcncrator s Phone# Gcncrator s US EPA lD No ` <br /> UL.TRAMAR, INC. (209) 563-5545 <br /> 525 WEST THIRD STREET PrrSon to Contaet <br /> TERRANCE FOX <br /> FAX# Customer Account Number,��ith TPS <br /> HANFORD, CA 93230 USA (209) 583-3282 1002367 <br /> Consult int 5 Nlmc and Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY PMou 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 /> GLneCahon Sik(Transport from) (name.&address) Site Phonc# BTEX <br /> Levels � <br /> BEACON STATION #1-641 PcrsontoContact TPH <br /> 1210 EAST HAMMER LANE ,TERRY UNRUH Levels <br /> FAX# AVG <br /> STOCKTON CA 95210 USA °e� <br /> C M <br /> Designated Facility(Transport to) (uame&addri—) Facility Phonc# Facility Permit Numbers <br /> v (510) 235-8778 <br /> o TPS TECHNOLOGIES INC. <br /> Pc.>'son to Contact <br /> R 20 RECYCLING LANE Cheron Rice/Dan ux-ash3ma <br /> FAX# <br /> L RICHMOND, CA 94801 USA (510) 231-4154 <br /> k <br /> 4) Transporter Namc.and Mailint,Address Transporter's Phone# Transporter s US EPA[D No <br /> LUTREL TRUCKING (805) 399-0246 Y <br /> 6315 SHOW ROAD 1'Lrson to Contact Transporter s DOT No f <br /> HERMAN <br /> FAX# Customer Account ccREL`imberwithTPS <br /> BAKERSFIELD, CA 93308 <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 ❑ �� �djtrj} <br /> 10-20% Cl Diesel ❑ �[f <br /> Clay ❑ Oilier ❑ 20%-over O Other ❑ <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> 10-20% ❑ Diesel ❑ <br /> Clay ❑ Other ❑ 20%_over❑ Other ❑ <br /> List any exception to items listed above <br /> Generators andlor consultant's certification I/We 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 wayof <br /> Print or Type Name Generator ❑ Consultant ❑ Si and date Month Day Year <br /> � �i Q CO !� 9� <br /> y Transporters certification Il We acknowledge receipt of the soil described above and certify that such soil is peing delivered in exactly the same 5 <br /> ocondition as when received IlWe further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> CL <br /> without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> fi Pnn!or Type Name Signature and date Month Day Year <br /> eta t c <br /> Gi' l <br /> Discmpancies <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above - <br /> Print or Type Name Signature and date <br /> rr. <br /> Please print or type <br /> TPS INVOICING COPY <br />