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03/23/2010 14:51 2099313,' -- PAGE 01/01 <br /> FREMOM LAWIRONMENTAL SERVICES, INC. <br /> Send payment to: Phone: 800.559-3274 EPA ID#CAR000171017 <br /> P.O.Bax 2875 Phone: 707-448.3700 U.S.D.O.T.#1484667 INVOICE # 2 1 8 2 4 <br /> Vacaville,CA 95696.2875 Fax: 707-445-3499 D.T:S.C-#3544 <br /> www.hazwastaetnovai-cont CA#274461 Date ,3 •-Z5•-to <br /> SITE ADDRESS BILLING/MAILING ADDRESS <br /> Customer Customer 4 <br /> 911, rJ 8vd��wgylds _I h ..� ' <br /> sro�khoh LA as ;Zly <br /> MAR 2 3 2010 <br /> E.P.A.# ��O f f Phone <br /> SAN J0Af!lJfld COUNTY <br /> Additional Contacts: 61N\'lRCl 'iM04rAL <br /> IIFAL 111 F'Cr liTMa!T <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 - 14 - 21 . 30 - 45 a 60 - 90 a 160 - 365 W/C WASTE CODE MANIFESTNUMBER QUANTIY UNITS PRICE AMOUNT <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) Or71 CA 221 4243a 6A <br /> Non-RCRA Hazardous Waste Liquid:(Used Anti-Freeze) CA 134 <br /> Non-RCRA Hazardous Waste UgUd:(.Oily Water) CA 223 <br /> Drained Used Oil/Gasoline/Diesel Filters <br /> Nom RCRA Hazardous Waste Solid(Oil Contaminated Debris,Soil) CA.223 <br /> Parts Washer Service CA 223 <br /> Non-RCRA Hazardous Waste Liquid(Brake Fluid) CA 343 <br /> Waste Flammable Liquid, N-0,S,,3,UN1993, PGll(Gasoline-Diesel) 331/D018 <br /> -, OPA <br /> it) <br /> 7,5 I <br /> 1 OLD ( 1l 0 p <br /> Ernpty Drums Provide © Remove A 1 V 59Q 10,90 159 Q.30g❑ 559 (9 P F. 3 sno YS-41--o <br /> Clor-D-Tett Q4000 Test Kit: Test Q Pass O Fail U Generator Knowledge PPM <br /> Transportation Charges/Additional Truck Time/Additional Labor/LAR Packing/Site Cleaning <br /> Clean: Labels OII r�3 ,7L q/FUbF OilyDebri <br /> SERVICES REQUESTED.�BY3�� 1 TAX <br /> cce t Ila ® P.O.# TOTAL CHARGES: r Q <br /> GBNRMTOXs CERNEICATIONI I hereby ticcl7a that me cantenls or this consignment ore fully and occorately descnbad above by prpper snipping Home and qre CIa95111etl,packed,markeq,and <br /> labeled,and are in all respects in proper condition for transportby nigtnvay accordng to opplicablastQteand national govcrnrpent regulallore. Ir omalame quantity genomton certlry fntlt1 <br /> hdvea program In place foreduce the volume and toxlany of waste genewed to the degree l have determined to be economically prclMlaableand thatave select-d the preafloablb method <br /> Of troofmCm,Storage,or d'nposal currently avaNOble tome which minimized the present and future threat to human health and the environment,OR,A I am a smog quantify genwator.l have mode <br /> =transported <br /> foifh effort to mtnimuo mywoste ppeneration and select the best waste mandgemsnt method thotis wailable tome antl that l can afford. AR used oil from me generate listed above <br /> tNll be transported only 100 focinfy permftrea by the State of Callfamio to product mad of into recycled oil 00110 ludilly that is regaled t0 eompsy with Federal regu tions appOcoble,to the <br /> management of vsed all. M reievont information regarding known or Suspected hazards associated with this waste has been dlsCtO$Ad. The customer Ogress to p rea�nable costs and alfdmey <br /> tees In in the collection of this abl' orlon- venue for u ses of this obit atlon 9nall be in Solana n4 , I declare under to I of e u Motthe fo of h true and correct, <br /> Dl$P L/RECYCLING FACILITY: ColleCtIon Station Industdal I Aedculture Gov medf Madn9 er Inco nal Lubdcattna <br /> l Oil <br /> [ Everitroort 4MIRoad kp.-Deva [ )Evergrbeli Oil,lrp. [ )b}etech EnNronmBfir4l Qorp. :[ 9Sky Ewronmonlal [ ]21st G8nWry EfN <br /> 44,J61 Road 30B X80 SmiUI Ave, 1420 S Cemenl Road 401 W.l:haruwl RaEd 2U35 Newlands Or.,Fast <br /> 1 DBvIB,CA 9WIS 2 New8115 CA SM :0 Fredonia,K5 W 4 QeniciB,CA 94510 5 Feml N I e 82d� <br /> 510-79i4d00 CAD 992dd1s87d .510.795-4400 CAD9M7418:' 316373-4451 KSDBe .: .. 514541-2128 CAL01PIP77e5752760.M/D 9wagSi9e <br /> PUd� c�<1d�✓ rca <br /> Pdnf Name Genera rs St®noturfs Dd to <br /> I b aarli Ihmi 1 read odd h v e alltltari i 'nd the above ' fed anerpTa� 1 erre side is form. <br /> mn bov_-rte .. rr .. <br />