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��. WORK ORDE,,SERVICE AGRF,EMENT
<br /> Evergreen Environmental Services N° 446798
<br /> dedicated to the pmn•Ctlon nl rhe en vironnlenl
<br /> To schedule a pickup, call Send payment to: Sales Order #
<br /> 800-596-9455 1>vcrcreen Oil. Inc.
<br /> 6880 Smith Ave.,Newark,CA EPA#CA0982413262 P.O. BOX 30517 �
<br /> 16540 S.San Peoro St.,Carson,CA EPA#CAD982413262 Lost Angeles, CA 9(H)30-0517 Date:
<br /> GENERATOR/JOB LOCATION BILLING INFORMATION
<br /> NAME CASH ❑CHECK❑
<br /> pRl?S r AUUItESg CUSTOMER CODE NO.
<br /> r✓ Z
<br /> !C1TY STATE ZIP CO- CITY STATE: ZIP CO. PO R
<br /> / IG
<br /> PHONE.N(1. PHONIi NO. PROFILE NO. CUSTOMER EPA ID NO.
<br /> l 'fit -;37y 1 1 1�. Li
<br /> PRODUCTINASTF, 07ANIFESr QUANTITY UNITS PRICE AMOUNT
<br /> CODE NUMISER
<br /> Used ail.Non-RCRA Hazardous Lubriuming CA 2,12N 7 Gal.
<br /> WaMc,Liquid Industrial CA221 Gal.
<br /> Wn•NCNA CA134 Gal.
<br /> U'�a.Ix.nx'ui•
<br /> a9 oa.•.n.,,n,„ml,u.ry.ii.•ens.un a±±I Gel.
<br /> MW 11101il.rnCu...... wi,L L:dn'MJ nxnrtnar_
<br /> Oil&Water,Nan-RCRA 11wardOLN W axle Liquid CA2'1 Gal.
<br /> Waste Solids and Sludges Gal.
<br /> Wash Out Each
<br /> unlined Uud Oil Piller Drum
<br /> Non-RCIt.A Hazardous Wasic Solid,(oily dehrhl CA223 Druni
<br /> Empty Drum, Drun1
<br /> TramilunaWm Hr,.
<br /> Non Ha/arel n, finer Gal.
<br /> Glccnl Bulk 501517 Gal.
<br /> Glcae Bu ('arc Gal.
<br /> ']'EST: Clor D'reeh 41NN�ppnt ❑Out D Tech 1011D Patz❑Fail ❑ tfaingen uclector lame're, ❑Pus, ❑ Fail
<br /> Field Scn we W,,,k Dc,rrilumn Total ChargeS
<br /> Other:
<br /> (ihm —
<br /> Vacrnnn cr,ia:,Time
<br /> Otto, ':n'd On Sim Off Sim 011 Load Start_ __Oft Ln;al lint Itanrn❑. 'ant ,i,®-,�a•..�f'
<br /> TS VJ Consolidated Manifest
<br /> LP t Cr;�rccn Oil.Inc. la rl'_Rlvn Ihrc.SyC. liccr_•rcnt Enc.So. Us HIM,
<br /> OSRII
<br /> Saulh A%e. G koaI 300 ❑ 4139 N.Valentine ❑ 15131 Clark:\cc I—I
<br /> Neo'ark.CA 945611 L%n ie.CA 95,616 Fnenu.CA 937222 Industry.CA 71745
<br /> ('A)98(AN741% it
<br /> (AD982446R74 C'AD9S244683'_ C':\I)(k)(A]9743_
<br /> I?v Cr_racn lim. yr. I'.,ergroen ling.sw r CI'R CFI[ Givenleal1:1
<br /> I bb1U S.San •dor 745:\We,l Bettew ill 1- -I 944 Ii..Slaunou Ace, 39'111 A'e\mit 3474'liven Circle
<br /> 9345
<br /> S:
<br /> Gm,m. .1(3 nna\1ann.C.\ -{ Lu.:\neelc*.CA'NNII I Union Cit,.CA 945,R7 V;lle,Spnnae.CA 7535'
<br /> C.\U7;167(C'Ar7^_tlCAD982446358 1.AhOnn1 IM21 C.\f1N11NP)15117 CAL1!f11L'14J11
<br /> __ Gcneralur CeniliCs that it Ill.,CuahlishcJ a Prngranu to reduce Ike col uinc or
<br /> SOLn'Cec l 011ectioll Station :1 Government qu:n,lilc,C a"lei, el the Iia/'arthw,,,:rye m llie deew daanawd by
<br /> ❑Mariae ❑ A;71Li CLlltUI'al C_I 111CILIStrial ••CIWMIM u,he Conw uicalll pitmicahl,
<br /> - 1 hereby cerfil'v Thal I pace read and have the authority to
<br /> bind_Ihe above IiMnd ];uneratm- flu ilia terms nn fie reverse
<br /> Retain sample # ( b C t side or this I'orrn.
<br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF 1 OUR OlL.
<br /> Per California Health and Sarefa Code Section 252511.9. 17ycrgrccn hereby.11h Ses Cu,lomer II1a1 Cusionler s shipment of used nil ma\' be
<br /> Irun.sponod to a G¢ility dial i, Iequiled to cuniph with 1'uderal regulations applicable it, nlanaettnenl Of used oil. flat that is 1101 1Cyuir0d s,
<br /> comply with die more Nil'ingeal rryuijetnenks applicable I0 ha!ardous zcasle managentent raciliiicx. Ctdirurnia I:wililic, [file handlC ur proCC„ u,Cd
<br /> Oi err rcyuired a, meet Ihox• nose stringent requirement,. ann
<br /> d wille al-nr-sl:ue I:Icililies Thal process u,ed oil elan meet Ihnsa reyuireinents.
<br /> h( C iWIuJC nu,l'e slringenl ICok &&Goll and prCVCnlion rcquiraatcut>, 01ginC0111" CCrlilicalion, al lank inlet lot\. and financial as,u anceN lot
<br /> class re :uu! accidental relea,e,. 11 is I:nvful In sdud usoJ oil la oui-ol-stale facilities Ih:d eomplt only „ilh ieder:d used ail nulnaermrnl \bindurd,
<br /> and Irl Ihe\e more ,Iringenl lequ rcnlCnl,. This nnlil'h llli:m i, !in' inlivniatinn purposes un
<br /> ( mc• (:i,•11,11cr...• Prin! Same• ::{ayl;lc C/ !)a! ,cner:nt�r' Print \slow
<br /> Si._n.u,rr
<br /> 6 'd 480ZLL1116O2 HIN 0213W/NIi HOZHW NN15 dLD :ET 80 SZ des
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