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Mar 12 09 08:25a tom price 209-365-6781 p. 2 <br /> u <br /> FREMOUW ENVIRONMENTAL SERVICES9 INCA <br /> Send Payment to: phone: 800-559-3274 EPA ID#CAR000171017 <br /> P. # INVOICE # <br /> O. Box 2875 Phone: 707-448-3700 U.S.D.O.T.#1484667 C�/# <br /> Vacaville,Ca 95696-2875 Fax: 707-448-3499 D.T.S.C. 3544 Date 1 7S <br /> CA#274461IN <br /> wwyv.hazwasteremovaLwm BILLING)MAILING ADDRESS <br /> Al/ey Customer <br /> Customer��j ydt% �/� <br /> Address ��� ���!' .i?AQ/r 7 N __ Address___ <br /> ty1 State IP City ---- -. —State Zip <br /> Ci m`�t�� <br /> E.P.A.# CIA t-ri'L 4R&171,0 Phone - - -- -- - Fax <br /> r��L�y'7 fax( ) Cell ( ) <br /> Phone Numbers: Office`J.`� I, <br /> E-mail: <br /> Contact: <br /> PRODUCT - SERVICE INFORMATION/PROPER SHIPPING DESCRIPTION <br /> WASTE MANIFESTNUMBER QUANTITY UNITS PRICE AMO T <br /> 30 60 90 180 365 T T Y N JHS CODE <br /> Non-RCRA Hazardous Waste Liquid (Used Oil) CA 221 00 tl � <br /> Non-RCRA Hazardous Waste Lquid (Used Anti-Freeze) CA 134 <br /> Non-RCRA Hazardous Waste Uquid (Oily Water) CA 223 <br /> Non-RCRA Hcaordous Waste Solid(Dd Contaminated Debra,Soil) CA 223 <br /> Non-RCRA Hazardous Waste Liquid (Latex Paint) CA 291 <br /> Drained used oil /Gasolene/Diesel/Filters N-A <br /> Combustible Liquid, N.O.S., NA 1993 (used Oil)III CA 221 <br /> Waste Paint Related Materials,3 UN 1263,FG 33t Doot <br /> Waste flammable Liquid N.OS.,3,UN 1993,PG 11(Gasoliner-Diesel) 331 DOl <br /> 331 <br /> Waste Aerosols. N.O.S.2.1,UN 1950 PG. D001 <br /> Empty Autres Provide D Remove D 5g ❑ i Og O 1S❑ 30g❑ 55g❑ S P F <br /> Clor-D-Tect Q4000 Test Kit Test❑ Pass❑ Fail ❑ Generator Knowledge ❑ 'PPM <br /> Transportation Charges/Additional Truck Time/Additional Labor/LAB Packing/Site Cleaning <br /> Additional Equipment Supplies <br /> Hazardous Waste Labels <br /> Used Oil Disposal Fee <br /> EmkamrLlWSerflbMOwdisftW NO Dole.CAM"WIN11112440s714 ("a)M44M TAX <br /> A We ti P.O.# TOTAL CHARGES: <br /> GENERATOR'SCERFIFICAIION: Thereby tlecbre lhailM conlenlsol thh consignment ora Nls and occuroles Oescrn>etl above by proper mippFBname arstle clue>Ried.packed.mprketl.and <br /> krieMd,antl we in all respects in proper condition lar hanspal by highway according to applicable riche and not'pnal government regulations. R I am o targe qumtRy genemlor.I cedify Ihot I <br /> have a program m place to mduce the volume and t.IcRy of wolle generated to the degree I have determined lobe mconamica0y practicable and that I have selected Ibe pacticabie method <br /> of treatment,storage,or disposal currents ovo[abb to nw which minimtrd lire prefanl odd future threat to Kumon health and Ire environment;OR.lF I am a small quanlRy generator,I have made <br /> a ymtl tails eMOri 10 minim¢e my waste gerreratnn erW thiel the bell wgsle management nrelhOd Ilial u av Hoble t0 me and that I can afford. All used oil from the genealor listed above <br /> wR be transported ons to a facility permitted by the Stole of Cellfornia tp produce used it into recycled oNOR.focal,that b mqu'rad to cannot,with Federal regublions opac.bla to ine <br /> morogemenl of used oA All relevant mlormation regarding known w suspected hamNs afsacbted wRh this waste has been discbsed. The customer agrees to po,reasonable costs and at lorney <br /> fees ineured in the coacloon of air,obi ohlon. Venue 1 l o <br /> ser of this obilan shell be in Solaro coup .I declare under e.n.111 of that the foracling is true and c <br /> D6POSAVRECYGLING FACILITY I (lection Station Industrial Agroulture Government Marine Other Indufhbl kcating <br /> on on <br /> QEvergreen ORtnc. Q Gemrol Embimor id Alaoaemmi,Inc. = VnRon/[RD Q Rom.Eo.ronmenfal <br /> 1 6M Smith Ave.,Weak,CA 94560 3 11365 Mile Rock Rd,Rancho Cosdeva,CA 95742 S 5136 Wesl Wesson,Ihaenin.AI85a/3 1 1515 3. r Rd.W.Sacramento,CA 9569 <br /> 51049Sd100 CAD 980337413 916351-0910 CAD 93083/103 9DO-30.9095 AID 00033]3!0 916.3 .514) CAD 0110035SA <br /> Q eommercld FRler RecTclla Q Indushln101 Q Aifrmont Landfill Ba 011 LLC <br /> 2 33210 Wedem Ave.,Unton City,CA 9463, 4 12911awme Ave.,Klamath Falb,OR 51 6 10110 Alknod Pas el-Lsem A91550 3 Logo Rd.Fallon,NV 89401 <br /> 510.437-mi, 511.331-9124 0[ 75 925-455-0300 CADS 132 -862-5032 NVR 000080655 <br /> NEW <br /> Pflnt NR Genaroto s signs a !D iv 2igrlct e <br /> Stale,law Requires ilial you keep Ihis Receipt/Bill of lading on Ste no I s an 3 years. <br /> To Rn-Aclivob or\e obtain on EPA a -Caslomer may contact DISC� 800-6186942 <br />