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3ILLING INFORMATION <br />ADDRESS <br />C{TY STATE ZIP <br />PHONE # <br />Send Payment to* <br />p_0, Box 1904 <br />Vacaville, CA 95696 <br />(800) 669 - TANK <br />PRODUCT PROPER (WASTE <br />SHIPPING DESCRIPTION CODE <br />Non-RCRA Hazardous Waste, Liquid 221 <br />Used Oil <br />Non-RCRA Hazardous Waste, Liquid 1 134 <br />Used Automotive Antifreeze <br />_Non-RCRA Hazardous Waste, Liquid i <br />oily Water <br />Non-RCRA Hazardous Waste, Solid <br />(Oil Contaminated Debris) _ <br />Waste Flammable Liquid, n.o.S., 3, <br />UN 1993, PG III <br />JOB SITE <br />Invoice <br />Inv.# 6357 <br />gate;__� <br />EPA # <br />NAME <br />V-DRES <br />rr - -- <br />CITY STATE ZIP <br />PHONE # <br />p � �¢ <br />MANIFEST` NUMBE�RANTITY UNITS <br />GAL_ <br />GAL. <br />GAL_ <br />LBS. <br />GAL. <br />CAD981694722 <br />PO# CASH Cf iECK <br />CUSTOMER EPA 10 # <br />7�� <br />PROFILE # <br />CUSTOMER ID # <br />PRICE i AMOUNT <br />e <br />i <br />J <br />Other'. <br />GENERATORS CERTIFICATION: I hereby declare that the rtorttents of this consignment are fully and accurately described above, by proper shipping name, are <br />ckwd, marked, labeled, and are in alt respects in proper condition for transport by highway according to appikrable ;tate and federal regulations. E <br />crsetiir�od, pa I <br />If I am a large quantity generator, I certify that I have a program in place to reduce the volume arta toxicity <br />disposalf urrently» reliable to me which m nimizes the !I <br />to be economically practicable and that I have selected the practicable method of treatment, storage, <br />present end future threat to human health and the environment: OR 1 am a small quantity generator, I have made a good faith effort to minimize my waste <br />generated and =.elect the best waste management method that is available to me and that I enn afford. I hereby certify that ►t! the information a s associated <br />in this and <br />all attached documents contains true And accurate deacription of the waste. All relevant information regarding known or suspected ha2ards associated with the <br />waste has borCn disclosed. I also certify that 1 have not mixe)d this wast(, with any other waste. Venue, for purposes of enforcement shall be IN 801ano County. I <br />declare under perjury that the foregoing is true and correct. <br />IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL. PLEASE SIGN AFTER READING. with fgderal <br />TTS F_nvironme-ntal Inc, hereby advises used oil generator that your shipment of used oil may be transported to a facility that is required to comply <br />regulations applicable to management of used oil, but that is not required to comply with the more stringent requirements applicable to haZ?rdous waste <br />management facilities.. Califbrnii facilities that handia or procesf� used oil are required to meet those morn, stringent mravent on M wird n0 requirements.vt,0f-t8tengineering <br />facilities that process up oil also muat mm -1 tho^- requirement. T hese include more stringent Iroak detection and p q <br />certifications of tank integrity, and financial assurances for closure and accidental releases. It is lawful to send u�d oil to out of-offacilitioc that comply with <br />onry federal used oil mnnagemgM standards and not those mare stringBflt requirements. This Notification is for information Pur poses onl� Rials <br />Test Pass [I Fail ICI PPM Lubricating Oil Industrial Oil <br />DISPOSAL/RECYCLING t-ACILI I I�.o iecnon Station IndtrtriAgricutiure �Govenxnerlt Marine SIJB L _ <br />mos EnvirormtenW <br />1515 S. River Rd. <br />Sacramento, CA 9%C-7 <br />CAD044OU3556 <br />1. Commercial Fitter Recycling Inc. 2. Crosby -Overton <br />33210 Wentem Ave 1630 West 17 St_ <br />Union City, CA 94587 Long Reach. CA 90813 <br />CALOOON1507 CAD02840%19 <br />3. Garris Environmental <br />535 Industrial Circle <br />White City, OR 97503 <br />EPA## ORQ000007781 <br />4. Industrial Oils <br />1291 Laverne Ave. <br />Klamath Falls, OR 97603 <br />EPA# ORD980980775 <br />5. Additional Charge' <br />--- -- - Total Charges <br />Late charge to all balances not pale! within 30 days. <br />Drum work invoice additional late Charge $35.00. <br />1 hereby certify that all the Infomnsltl0n submitted in this and all attached documents Contains true and accurate descriptions osed- <br />Of 7Ste All relttwant inforrnatton regarding known or susper a -- -- ---- ed <br />e d hazards associated with the waste has been disclosed - <br />All_ _ . <br />Signature j <br />rivers Signature _ G nerator's _ <br />