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TI'S Technologies Soil Recycling <br /> 'r � Manifest# <br /> Manifest <br /> y , <br /> est Non-Hazardous Soils <br /> Date of Shipment tic5ponsrbit for PI)nxnt TransporlcrTruck# I utlitti 0 ( Ix bN 7f'S 1 oad # <br /> BELS11I RE t_l_ , 4 = -00 n <br /> r ,rn r,tor 1 imt in,i lidhi 1,Addrr ritor,I'hont it ( r m r itor,LN ITA 11)No <br /> TI-Haul Inti�rnat iorial <br /> 2721 N Central Ave. Pcrson to C ontau <br /> Phocnix , AZ 85004 <br /> 1AX# C nrl.mltr Attouni Nurrrbtr t ith Tl'S <br /> Con,ullint ti Nim( ind llelltn,AddiLss CtmSLIt)nt e I'liont 0 <br /> 619-485-0100 <br /> SOTA PLr%on to Contact <br /> 19980 Via Tazon #130 JUn MrAndrnw <br /> fan Diego, CA 92127 FA X# CustonurAccountNumbtivNithTi'S <br /> Cc,ncrihon SitL f1rtn,porl horn) fnaort&addre,til Slit.Phunt.31 87 LX <br /> I 1 P U-Hall 1 - <br /> I'e.rsnn to Contact 7 PH a <br /> e 2701 % . Wilson Way <br /> ,• .ro Stockton, CA FAX#e I AVG <br /> � Le_vel, <br /> a DE—,il,nattd Fietlltt (Transport to) manic it addn J Facility Phone.# Facilit% Permit Numbtrs <br /> TIS i tart <br /> b - <br /> s i a = r Y t PEr�on to Cont,ct <br /> .'t ' <br /> % t <br /> FAXt t 1l"+l 1.4 <br /> Transportu NamE and Maillnh AddreSs Transports r s Phone# Tt an porter s LAS EPA 1D No <br /> vt- t It <br /> t P 1 01Person to Cotrota`t Tr inti}�Qr car s QQx 1s3o x- <br /> _ lCo, <br /> l S r�t�rl^4Y 'r3 � It. <br /> 1 rt f Cr <br /> 1•r <br /> T CusturQiC pquUtj�,4umberwithTPS <br /> B.E.S.I.#j10106.0 �t <br /> f',S4i iq,a <br /> Description of Sod Moisture Content Contaminated by Approx Qty Description of Delivery Cross Weight Tare Weight Net Weight <br /> sti 0-10% ❑ Gas ❑ <br /> ' Sand ❑ Organic❑ >4aF ClayOther ❑ 10-20% ❑ Diesel ❑ {{ { t J C (`�l v c <br /> ❑ 20%-over 0 Other ❑ 1 ) l r <br /> 0-10% ❑ Gas ❑ <br /> h Organic <br /> 10 20% ❑ Diesel ❑ <br /> Stay ❑ Other ❑ \ 6Y <br /> 20%-over❑ Other G <br /> List any exception to items fisted above c C ~ <br /> p� Generator's and/or consultant's certification I/We certify that the soil referenced herein is taken entirely from those soils described in the Soft Data ' <br /> Sheet completed and certified by mews for the Generation Site shown above and nothing has been added or done to such soil that would alter it in i <br /> l+ any zany <br /> Print or TyIx Name Genttrator LJ Consultant ^1J Signature and date /� '�1 Month Dat Yrar - <br /> Transporter s certification I/We acknowledge receipt of the soil described above an certify that such soil is being delivered in exactly the same t <br /> } * o condition as when received 1l We further certify that this soil is being directly transported from the Generation Site to the Designated Facility <br /> y without off-loading,adding to subtracting from or in any way delaying delive to such site <br /> Pnntor ame Signature a date ,r Month Day Year <br /> - S Discn}ranacs <br /> i w <br /> j C Recycling Facility ce rtifies the recupt of the soil tour red by this rrianifeO except as rioted above <br /> V� Print or T ypt Nina Stgn tun and dale rt <br /> r <br /> TrnfvSPORTER'S COPY <br />