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r ' <br /> Technologies Soil Recycli <br /> r + inifest Non-Hazardous Soils ki r 4 ',,Manifest# y <br /> Date of Shipment Resp risible for PamenE Transporter Truck# Facility# Given b TPS Load# <br /> Uenera or A 6014 0 <br /> Generator s N3mc and Billin Address Gcri vitor s Phoc# Gini ator s US EPA ID No <br /> ULTRAMAR, nNC. (209) 583-5545 <br /> 525 WEST THIRD STREET Person to Contact d <br /> TERRANCE FOX <br /> HANFORD, CA 93230 USA FAX# CustoinLr ACC it NumbLr with rN <br /> ( 209) 583-3282 1002 67 <br /> ConGultmt s Namc and Billet Address Consultant s Plione# <br /> HORIZON ENVIRONMENTAL (916) 939-2170 <br /> 5011 GOLDEN FOOTHILL PARKWAY `r",b 't�` ARKER <br /> SUITE 7 _ <br /> EL DORADO HILLS, CA 95762 USA FAX# CnSkOnlirAccount Ni with TPS <br /> (916) 939-2172 4HORIZO <br /> 0-mr-ition Site(Transport from) (name.&addrebs) Site Phone# BTEX a a <br /> BEACON STATION #1-641 (209) 5$3-3247 Lc°els <br /> EAST HAMMER LANE - — Peron to contact " -- — TPI-r- <br /> 1210 <br /> JERRY UNRUH °els <br /> w <br /> + FAX# AVG <br /> STOCKTON, CA 95210 USA (209) 583-3282 Levels <br /> VDesignated Fauhty(Transport to) fuanie&address) Facility Phone# Facility PLrmit Num <br /> `o TPS TECHNOLOGIES INC. ( 510) 235-8778 <br /> 20 RECYCLING LANE Pcrso toe ntact <br /> L�. VRiae/D. Muraiiihima <br /> FAX# <br /> d RICHMOND, CA 94801 USA (510) 231 -4154 <br /> z; Trans orter Name and Mailin Address Trans Drier s Phone# Transporter s US EPA ID No z <br /> C� �UTREL TRUN IN (8@5) 39q-0246 r <br /> 6315 SNOW ROAD Person to contact Transportcr s DoT No <br /> HERMAN <br /> BAKERSFIELD, CA 93308 FAX# CustonWLA TftffberwithTPS <br /> Description of Sod Moisture Content Contaminated by Approx Qty Delcriptlon of Delivery Gross Weight Tare Weight Net Weigh <br /> Sang ❑ Organic 130-10% ❑ Gas ❑ <br /> Cie ❑ Other ❑ 10-20% ❑ Diesel � (}j(Ij,J� <br /> 20%-over❑ Other <br /> 0-10% ❑ Gas ❑ <br /> Clay ❑ Other Sand U is O 10-20% ❑ Diesel ❑ " <br /> E 0%-over❑ her ❑ <br /> Lust any exaephon to de;;listed aboi+ <br /> i <br /> e I � <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 comple d and certify d by melus for the er f n Site shown above and nothing ha-z led or done to such soil that would alter it in <br /> any way <br /> Pitnt or Ty Ge ator Q Consultant ❑ Si re an th Day Year <br /> Transporter's certtftcatton l/We acj&ozvledge receipt of the soil described above and certifyt Oil is Berna ivered in exactly the same <br /> Ocondition as when received I/W further certify that this sod n is being directly transported I �nera Site to the Designated Facility <br /> H without off-loading,adding to,subtracting from or in any way delaying delivery to such site <br /> i'nnt or T Name Signa and date Month D yr QYear <br /> panties j <br /> LIZV <br /> CRecycling Facility certifies the receipt of the soil gpvered by this manrfest except tis noted above <br /> ' j% print or Type Name Signature an a �� s <br /> 4uuui»7 <br /> � ��►� Li Icy <br /> Please print or type L� <br /> TPS INVOICING COPY <br />