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WORK ORDE.4ERVICE AGREEMENT
<br /> �:ZJ Evergreen Environmental Services N° 473815
<br /> deJinnr<I to if,,Prorrcpaa a(the ran•irnnutrurl
<br /> vTO schedule a pickup, call Send payment to: Sales Order #
<br /> 800-596-9455 Lvergreen Gil. Inc.
<br /> 6880 Smith Ave..Newark,CA EPA#CA0962413262 P.O. BOX 30517
<br /> 16540 S.San Pedro Sr,Carson.CA EPA#CAD982413262 Los .Angeles,CA 90030-0517 Date:
<br /> GENERATOR/JOB LOCATION BILLING INFORMATION
<br /> NAME NAME. CASA ❑ CHECK❑
<br /> ��y #
<br /> ADD F.SS �r1 � ADDRESS CUSTO>91SIt CODE,rv0.
<br /> CITY STATE 'LIP Co. CITY STATE. ZIP CO. PO 4
<br /> [L
<br /> vrN , eor .lcrsrotiEx FPA In yo.PHooruonr so, rn
<br /> `t-1 —33 ( 1 t
<br /> li'AS'1'E MANIFEST QUANTITY UNITS I-RICE AMOUNT
<br /> PRODUCT CODE NUMBER
<br /> Used nil-Non-RCRA Huardnus Lubricating CA22 — Q� Gul.
<br /> W;utc.I i9uid h,Justrial CA221 Gal.
<br /> I..... N,.u.Ml KI ono-',- CA 14 Gill.
<br /> NSae IJ�oWvn
<br /> kp N':orc 6n,mw,uly LaMed.N(IS.sn laniinivn Gal.
<br /> Oil R Water,Mm-RC'RA Hward,ms Wase Liquid CA2°I GA.
<br /> Waste Solids and Sludges Gal.
<br /> Wa.+h Ow Each
<br /> Drained Used Oil Filters Drum
<br /> IN oil-RCRA I L,eu'dous Wale Solids(oil) tl.-hris) CA223 Drum
<br /> F.ulply Dons Drum
<br /> Tianspnrwholl Hrs. ..
<br /> Nan Ha,arduu,\1 er Gill.
<br /> Glycol Bulk 5tp5l7 Gal.
<br /> CI)'rnl ROV Cane. Gil.
<br /> TEST: Chu D Tech 41I1N?�PPln ❑Clot D Tech It100 Pas n Fail ❑ Halogen Deteetor/Flame Tess ❑P ❑Fail
<br /> Field Sen•ice Werk Ihsaription Total Charges
<br /> Other:
<br /> Other:
<br /> Vacuum 'ices'Time L
<br /> Ow air nl DO SIIC 011 Site_Off Laall Stan Off 1 n:ul find Raurll m J J
<br /> TS Consolidated Manifest
<br /> Evare."en Oil.Inc. rcerns:en Ger.Sea Evergreen Enc.Src. AJS Filter
<br /> 68811 Smith ace. ❑ Ru;nl.. 4179 N.Valentine 11 15131 Clark Ace.
<br /> Newark.CA 94%0 Ihn'is.CA 95616 Fresno.C:1 93722 lailuslrv,CA 41745
<br /> C.AD98u8874 IF CAD96'_446874 (AD98''Jd/iS8_' CADUNN)743'_
<br /> ❑ Gs ergrran line.Se ❑ F.mmmcn Fm.Sec L� CFR ❑ CPR ❑ Gre¢ndad talc.S'C'
<br /> 161aN S.San I'• 0 745 A\Feu 13euern is LJ '7JJ I-:.Slau.on:\re. i i�lo Wcsteru 1474 Tovan Circle
<br /> ('arum G\9 46 Suae pLHIZ.C':\93451 1 o,Alccles.CA 90(111 I Inion Cil\'.C A 94.187 Valles'.SPriin s.CA 95352
<br /> CAD9SI69 0 CAD91'_4J6.h8 CALINinloo'_I ('AIfNNN19151A CAL6002143 11
<br /> Gena amt u.mll :lhn it 11:1,t wbiehed a pm roll to room the yaluntC In
<br /> Source: CDilcctol StlYl011 ]Government .pl;mury-.l 1 ,i in I I ... h rd m.'N'.'le u,Ih•Jouroe tl ....in.,i he
<br /> �u Marllle ❑ A,grieultural O Industrial gn,el Alec t, Ix u.onunucall, prau.able.
<br /> I herchv certiPo 111ave rea
<br /> 1( 1 hd and haw Bre lwhnrih to
<br /> bind the above listed Generator to the terns on the MCM
<br /> Retain sample #-to
<br /> IMPORTANT NOTICE RECARDING THIt, DISPOSITION OF YOUR Oil..
<br /> Per California llealth and Safety Cole Section 252511.9. F%crgreen hercbc udvisel cnuomer that customer's shipment of aged nil olny he
<br /> Inlllspmled tO ,I I wilds that w leytnad R, iontpl, ilh leduol til tons :ppir Ib o to m tilt eluent of 111CLI oil. hal that in not rcqu,rcll to
<br /> comply a'ilh the mole ,arun_enl myou nncros :q,pht,d.l. to hoaudou. "il.te litil nJelnew I tultocs. C'ddulni.l facilities that handle of rl'xCN. u.cd
<br /> iI are rcyuurd to "loci (how nulr C sn in_cnl cup-- nr Il , and .om. o,t of t I i I rlui .' Ih n prose: , d nil al m 11 dnaG I qua ntcnl..
<br /> No
<br /> utclude nnn� Ann un Icuk dcn•.uon and pl•lcnnon requu InenlM en in Inc ccWlr ainm of rink cin uul lin:unt d 1"olonce, lit
<br /> 'h Hdlg 1.n,l :n PdClllal It ica'c' It r', l,l\\'l til I„ gond uKd ,it lo til of-'I,ae 110.)1111 : 11.- Conlplt endo ,rill Is,.d Oil Illall I,U1lGtl Yullldanl'
<br /> m nut Ihese morn ngcnl reyu!r.•n,enn_ Thi. 1uli0C;,,n i< Irninlin'ntauOn pm'POcaS ooh.
<br /> I`ri r tii_n:durt Pnlll. N:nnr Roulr _ Dme lel nor'. alt Print �mne P
<br /> E 'd
<br /> 11,B02LL11,60a HIN 3N3W/WI-1 HQZHW WNis dbO =ZT 80 SZ deS
<br />
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