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.�� CONTRACT ENVIRONMENTAL SERVICES INC. <br /> 925 S. Broadway, Ste 251 • Cortez, Colorado 81321 • 970-565-1198 <br /> Landfarm Soil Delivery Manifest <br /> Landfarm Location: NE1/4, S18, T39S, R26E, San Juan County, UT <br /> I certify that this is RCRA-exempt Oilfield Waste, Signed: <br /> Delivery Date (mmidd/yy): Delivery Time: <br /> Volume Delivered (est. cu. yd.): <br /> Description (soil type, color, etc.): <br /> Soil Origin and Generator Information: <br /> Location or Well name: <br /> Section: Township: Range: QUQt or U.L.: <br /> Generator: <br /> Address: <br /> Phone: <br /> Send Invoice to (if different from above): <br /> Name: Job or P.O. no.: <br /> Company: <br /> Address: <br /> Phone: <br /> Transporter Information. <br /> Trucking Company: <br /> Address: <br /> Phone: <br /> Driver: Truck Number: <br /> Time left site: Time arriving at landfarm: <br /> Remediated soil will either (check one): "GPS" N <br /> 0 remain at landfarm, or <br /> 0 return to its originating location. W <br /> Depositing Information: 3 2 1 <br /> Grid Number Deposited in: <br /> Individual Grid <br /> 4 5 6 <br /> Shade in approximate area <br /> accounted for by the soil in the g 8 � <br /> appropriate grid square: <br /> Soil Contamination Data: 10 11 12 <br /> Field headspace: <br /> TPH: SAR: 15 14 13 <br /> Elec. Cond: <br /> EPS. 16 17 18 REPROGRAPHICS 111114C <br /> Date tested: V <br />