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06/27/007 11:17 2094650723 TOYS R US DC 58 <br />4,y Send Payment to: <br />P0. BOX 1904 <br />Vacaville, CA 95696 <br />(800) 669 - TANK <br />BILLING INFORMATION <br />NAME JOB SITE <br />NAME <br />ADDRES �—.—�---� -. <br />PAGE 02/03 <br />Invoice <br />Inv, #f <br />Date: <br />EPA #;~� <br />- CAQ-9 694722 <br />ADDRESS — L/ <br />CITY <br />STATE ZIP <br />CITY <br />PHONE # STATE / p <br />C.% <br />PHONE # <br />PRODUCT PROPER ,� `" �` 4 -� — <br />SHIPPING DESCRIPTION WASTE MANIFEST NUM6ER <br />Non-RCRA Hazardous CODE QUANTITY UNITS <br />_.``— Waste, Liquid 221 <br />Waste Corrosive Liquid <br />Von-RCRA Hazardous Waste tl <br />Oil Contaminated Debris) <br />Haste Flammable,,IV4 ff <br />1N19�.„ <br />Vaste Flammable Liquid n.o.s., <br />Saint Related Material), 3 UN1263, PG III <br />'ansportation Charges <br />ained Used Oil Filters <br />"Pty Drums <br />ditional Labor <br />er <br />er. <br />�r. <br />> t� • a 7—C, 2 C. G. -Z- <br />Pass ❑ Fail D <br />'OSALIRECYCLING FA ,LIC TY: Couec&on Station P dM <br />-� ustriat <br />Agriculture <br />mmereiai f=ilter Recycling Inc. <br />'10 Western Ave, 2• rosby-overion <br />on CA 11 94567 1�3o west 1 � Si. <br />�� Long Beach, CA Slow <br />501 CAD02840W19 <br />PO# CASH CHECK <br />CUSTOMF_R EPA ID # <br />PROFILE # <br />CUSTOMER ;1D <br />PRICE AMOUNT <br />GAL <br />COAL. <br />LBS. <br />oG <br />GAL_ <br />I HOURS <br />EACH <br />EACH <br />EACH <br />Government IMarine <br />3.. Other <br />-,; , s C1>0 <br />6-s <br />?5 <br />R AI cOM%jAWE FEE s — Total Charges �r7 <br />�0 all balances rtot Pam wtsth 3r an 48Y'��^-- — <br />$35 ed docutr►entS CO^tains tN8 and wQcurate descriptions' <br />xork invoice additional tate ohSMO _--e — --- <br />that all the Information submMed to this and alt attach — ed with the waste has been disclosee- <br />,y certify known or suspected hazards asseciat — — ' - <br />waste. Ait relevant Information regarding —, ' <br />Generator's Signature <br />