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TPS Technologies Soil Recycling „ <br /> ?525 <br /> anifest Non-Hazardous Soidsf(Ulanlfest �` <br /> hr met Responsible for Payment Transporte Truck# Facility# Given by TPS Load# <br /> Generator04 00014 5 <br /> r s Namcand Bil tng Address Gcturator�Phone 4 Gi-ru rotor s US EPA ID No <br /> RAMAR, INC. (209) 583-5545 <br /> WEST THIRD STREET PcrsontoContact <br /> TERRANCE FOX <br /> FAX# Customer Account Number with TPS <br /> HANFORD, CA 93230 USA (209) 583-3282 1002367 <br /> Conyultant�Namc-ind Billing Address Consultant s Phone# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY PLmon to Contact <br /> SUITE 7 GARY BARKER <br /> FAX# Customer Account Number with TPS <br /> EL DORADO HILLS, CA 95762 USA (916) 939-2172 4HORIZO <br /> GcnLration Site(Transport from) (na)m£a address) Sitc Phone If BTEX <br /> s <br /> Levels <br /> BEACON STATION #1-641 (20q) 5583-2247 <br /> Person to Contact TPH <br /> c 1210 EAST HAMMER LANE TERRY UNRUH Levels <br /> w FAX# AVG <br /> c <br /> STOCKTON, CA 95210 USA Levels ° <br /> VDesignated Facility(Transport to) (Mame&addrr,b) Facility Phone# Facility Permit Numbcrs <br /> `o TPS TECHNOLOGIES INC. (510) 235-8778 <br /> � <br /> 20 RECYCLING LANE PcrsontoCantact Cheron Rice/Don lurashina <br /> +~b, FAX# r <br /> RICHMOND CA 94801 USA (510) 231-4154 <br /> Transportcx Namc and Mailing AddrLss Transporter s Phone.# Transporter s US EPA ID No <br /> LUTREL TRUCKING (805) 399-0246 <br /> 6315 SHOW ROAD Person to Contact Transporter a DOT No <br /> HERMAN <br /> FAX# Customer Account Number with TPS <br /> BAKERSFIELD, CA 93308 4LUTREL <br /> Description of Soil Moisture Content Contaminated by Approx Qty Description of Delivery Gross Weight Tare Weight Net Weight <br /> Sand U Organic❑ 0 10% ❑ Gas U <br /> Clay O Other ❑ <br /> 10-20% ❑ Diesel ❑ <br /> 20%-aver ❑ Other ❑ <br /> Sand ❑ Organic❑ 0-10% U Gas ❑ <br /> Clay ❑ 00,E ❑ 10-20% ❑ Diesel ❑ . <br /> 20%-over❑ Other ❑ <br /> List any exception to items listed above a <br /> Generator s and/or consultant's certification I/We certify that the soil referenced herein is taken entirely from those soils described in the Soil Data <br /> Sheet completedlind certi ed by melul s for the Generation Site shown above and nothing has been added or done to such soil that would alter it to ; <br /> any way ►,(*f T �j�"� "4C. TAM 4 <br /> Print or TypJe�Name Generator ❑ Consultant ❑ Si re an date M nth I Year <br /> t Transporters certification I/We acknowledge receipt of the soil described above and certify that such sod is being delivered in exactly the same <br /> condition as when received IIWe further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> H without off-loading,adding to,subtracting from or in any way delaying delivery to such site t <br /> Print or Type NameSsgnatu an date Month Day year <br /> x <br /> Discrepanaes <br /> li <br /> Recycling Facility certifies the receipt of the soil covered by this manifest except as noted above <br /> Print or Type Name 5igna and date Y <br /> f„ <br /> Phrase print or type s <br /> TPS INVOICING COPY <br />