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S Technologies Soil Retyclin t <br /> Manifest Non-Hazardous Soils t <br /> -Date of 5 pinentResp�s�tb�lea Payment Transporter Truck# FaStlitv4# G�yg�S TPS ,j ppd M <br /> tJt�rtAA . d B1J] iAddnws G��}�ryTt ,s Pr -5545 GenLratnr s U5 EPA ID No <br /> I L10 7 <br /> 525 WEST THIRD STREET PLrson to Contact <br /> TERRANCE FOX <br /> r <br /> Y <br /> 'HANFORD, CA 93230 USA '? 091 583-3282 CriS�o� 530NumbLrwithTPs <br /> 1ronsultant s Namt.and€3111tH Addsu <br /> ress Conitants Phone# <br /> HORIZON ENVT90NMENTAL (916) 939-2170 <br /> 1'�` 5011 <br /> GOLDEN FOOTHILL PARKWAY '1jXkVCcMKER s <br /> SUITE 7 ' <br /> EL DORADO HILLS, CA 95762 USA F 416) 939-2172 Cu�o�����gl�l�tNumbcrwlthTPS <br /> GLnlratlOn SitL(Transport from) (mini b'address) Site Pllonc# 13TEX <br /> BEACON STATION *1-641 (209) 583-3247 Ltvels <br /> 1210 EAST HAMMER LAND Person to Contact TPH - <br /> e i J9RRY UNRUH Levels <br /> FAX# AVG <br /> H STOCKTON, CA ,95210 USA (209) 583-3282 Levels <br /> VDJLslgnated Facility(Transport to) (tante&addrtgs) F(c5ti0)Ph ne# -8778 Facility Permit Numbers <br /> c TPS TECHNOLOGIES INC, <br /> N 20 RECYCLING LANE P son contact <br /> t <br /> kf <br /> FAX# <br /> RICHMOND, CA 94801 USA (510) 231-4154 <br /> Waw <br /> rans crier Name and Martin Address Trans ortcr s Phone# Transporter s DJS EPA Ip No <br /> nA .U�t'REL TRUCKING (8�D5 3 399--0246 , <br /> 6315 SNOW ROAD Person to Contact Transporter s DOT No °R' <br /> HERMAN <br /> BAKERSFIELD, CA 93308 FAX# Cu4wtRrLtNumber with TPS <br /> Description of Sod Moisture Content Contaminated by Approx 4ty Description of Delivery Gross Weight Tare Weight4tight <br /> Sand O Organic❑ 0-10% ❑ Gas ❑ ! <br /> Clay ❑ Other ❑ 10-20% ❑ Diesel El <3 J[ <br /> Tow <br /> 20%-over ❑ Other ❑ <br /> Sand ❑ Organic❑ 0-10% ❑ Gas ❑ <br /> 10-20% ❑ Diesel ❑ <br /> Clay a Other O 20%-over❑ Other ❑ <br /> List any exception to items listed above k <br /> 3 k r 3 <br /> Generator's andlor consultant's certification IIWe certify that the soil referenced herein is taken entirely from those soils described to the Soil Data i <br /> Sheet comple d and certifie by melus for the Geerttio ite shown above and nothing has been added or done to such soil that would alter it in t <br /> any way :41 Ll,A <br /> OF <br /> Vo o ype Name rotor ❑ Consultant ❑ Signa Month Day Year <br /> dayate + <br /> D4-C dq <br /> zzf=� 1 7 <br /> Transpdrter s certification Il We acknowledge receipt of the soil descri ed abo a and certify that such soil is being delivered in exactly the same <br /> ocondition as when received IIWe further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> Q with au -loading,adding to,subtracting from or in any way delaying delive such site w <br /> Pnn r Name Signa fdate Month Day Year <br /> Z G r <br /> Dascrepanc <br /> t <br /> U! <br /> CkPnn7t :::::- <br /> rtifies the receipt of the soil covered by this manifest except as noted above s <br /> i Signa[u �!te n h 4.i <br /> /c;:2 <br /> View print ar tYpe r "Il 1�t <br /> TPS INVOICING COPY <br />