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May. 27. 2010 9: 34AM WORK ORDER/SLR`V)No. 2806;RIP. IIEN'T <br /> Evergreen Envenmental Services�OR N° 482613 <br /> dedlrvred ro rbc Prolechon of rhe erinfronrrreul <br /> To schedule aicku Send p p, call e d payment to: Sales Order # <br /> 800-596-9455 Evergreen Oil,Inc. <br /> 6680 Smith Ave.,Newark,CA EPA#GAD982413262 P.O. BOX 30517 �+ <br /> 16540S.San Pedm St.,Carson,CA EPA*CAD9e24132e2 Los Angeles,CA 90030-0517 Date: ��J •�� <br /> GENERATOR/JOB LOCATION BILLING INFORMATION <br /> ME w NAME CASH Q CHECK❑ <br /> 44%. tt <br /> DD\SS . i tM�/� ADDRESS P�& CODE no. <br /> 1� d <br /> TTY STATE ZIP CO. CITY STATE ZIP CO. PO k <br /> � , r <br /> PHON%O. PHONE NO. PROFS NO. CUSTO\IER EPA In 190. <br /> z,Zy <br /> PRODUCT WASTE MANIFEST QUANTITYCJNITS PRICE AMOUNT <br /> CODE NUMBER <br /> tlscd oil,Non-RCRA lilozardous Lubricating CA22 17 k% Gal. <br /> Waste,Liquid Industrial CA221 Gal. <br /> lfM.d Ao,oma,ree A•,16ct+t,NamACIU I!Uado CA 13d <br /> WSae O uki Gal. <br /> AO H'rae CoeaadDte LI I n.09.N� CA7�t� <br /> 199)in oil coau,niaual•idf h� eu r{101R6 Gal. <br /> Oil&Water,Non-RCRA Hazardous Waste Liquid CA221 Gal. <br /> Waste Solids and Sludges Gal. <br /> Wash Out Fath <br /> Drained Used Oil Filters Drum <br /> Nan-RCRA H=rdous Waste Solids(oily dcbns) CA223 Drum <br /> Empty Iliums Drum <br /> Transportation Hrs. <br /> Non Ha2ardous Wa Gat. <br /> Glycol Bulk S0/50 Gal. <br /> Glycol Bul Coe;. ""��'' Gal. <br /> TEST: Ctor D Tech 4ur17t4�ppm ❑Clot D Tech 1000 Pass❑Fail ❑Halogcn Dciccwl lame Test ❑P ❑Fail <br /> Field Sen9ce Work Description: Total Charges <br /> Other: <br /> Other: <br /> Vacmlm S vices Time } <br /> Out of rd On Site Off Site Off Load Sian Oft Load End Return to Pard <br /> t688 <br /> Consolidated Manifest <br /> rccn Oil,Inc. Eve een Em'.Svc. Ener reen Env.Sre. tfS Firr0 Smith Ave. gond 308 ❑4139 N.Valentine ❑ 15131 Clark Ave. ❑ <br /> Newark.CA 94560 Oavis.CA 95616 Fresno,CA 93722 Industy,�C�A 91745 <br /> CA098088/Sv <br /> CAD982446974 CAD982446882 CADOM7432 <br /> Evergreen ❑ Rvcrgrccn Env.Svc, C[R ChR Greenleaf Env.Svc. <br /> 11 <br /> 16604 S.S745 A\Vest Beueraviu 944 E.Slausnn Aro. 33210 Western 1473 Toyon Circle <br /> Carson,CASanta filaria.CA 93454 Los Anggeles,CA 90051 Union Cityy,CA 94587 Valleyy Sppringgs,CA 95352 <br /> CAD98169CAD98244058 CAL008110021 CALOW1507 CA1.0002t4{11 <br /> Generator ceinifies that it has established a progo-n to redace the volume or <br /> Source: Collection Station ❑Government quantily&toxicity of the hazardtws waste to rhe dcgrre docniuned by <br /> ❑Marine ❑ Agricultural ❑ Industrial genoralor to be econnmicolly practicable. <br /> I hereby cerlify that I hove read and have the aulhm-Ily to <br /> ` bind the above listed generator to the terms on the reverse <br /> Retain sample # C Side of this form, <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL, <br /> Per Cnllfornia Realilt and Safely Code Section 25250.9, Evcrgreen hereby advises customer that customer's shipment of used oil nluy be <br /> transported to n facility that is required to comply with federal regulalions applicnhle to management of used oil, but [lint is not required 10 <br /> comply with the more stringent requirements applicable to hazardous waste management facilities.California facililies that handle or process used <br /> oil are required to meet those more stringent reduircinents,and some out-of-since facililies that pmcess used oil also meet those requirements. <br /> These include more Stringent leuk detection and prcvcntion requirements,engineering eeitifiemions of lank integrity, and financial assurances for <br /> closure and accidental releases. It is Inwfol to send used oil to out-of-slate facilities lhal comply only with federul used oil management standards <br /> tui of these more Stringent requirements.This notification is foc information purposes only. <br /> n �,a.• Cin.,ah i,•o <br /> ID'-;.,t Arn.,.a t7 n„ta o rl� n_:-.. AL-.... Y"_._ <br />