Laserfiche WebLink
`1h,,l WE ACCEPT VISA & MASTERCARD <br /> &—CLEARWATER �� <br /> ENVIRONMENTAL MANAGEMENT, INC. <br /> REMIT TO: Bill of Lading <br /> P.O. Box 2407 UNION CITY, CA 94587-2407 P.O. Box 349 SILVER SPRINGS, NV 89429-0349 Invoice # 196026 <br /> (800) 499-3676 FAX (510) 476-1786 (775) 577-9001 FAX (775) 577-9199 <br /> CAR 000 007 013 NVD 982 358 483 <br /> (800) 471-2105 <br /> Date 3 <br /> BILLING INFORMATION JOB SITE <br /> NAME NAME PO# CASH CHECK <br /> AnfOf)if)-) er riseU-Ohn <br /> ADDRESS ADDRESS CUSTOMER EPA tD# <br /> • <br /> gq(08 2V n r ' 1 t9al L NG M 09 N 3 93 <br /> CITY STATE ZIP CITY STATE ZIP PROFILE # <br /> ssfocop CA 2,08 Sipa.ton CA <br /> PHONE NO. PHONE NO. CUSTOMER ID# <br /> ( Z09 ) 1`13 615 ( ) EAlOou) <br /> PRODUCT PROPER WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> SHIPPING DESCRIPTION CODE" <br /> Used Oil, Non-RCRA Hazardous <br /> Waste, Liquid 221 <br /> Used Automotive Antifreeze, Non-RCRA " <br /> / <br /> I m <br /> Hazardous Waste, Liquid 134 co2b8Z97JJt 001 DA 125 <br /> Oily Water Non-RCRA Hazardous <br /> Waste, Liquid <br /> Non RCRA Hazardous Waste Solid <br /> Oil Contaminated Debris/Soil <br /> Waste Combustible Liquid nos 3 <br /> UN1993, PG III - <br /> Non Hazardous Waste Liquid <br /> Non Hazardous Waste Solid <br /> Transportation Charges <br /> Washout Charges <br /> Drained Used Oil Filters <br /> Empty Drums •1VW OJ O= r <br /> Additional Labor <br /> Pressure Washer <br /> Other: <br /> DISPOSALIRECYCLING FACILITY: Collection Station mdustri 1 Agricunure Governmem Marine TOTAL <br /> Alvisu Independent oil 7�Clearwater Environmental Mgmt.IncSiam 53]5 S e Water <br /> Ave, Vernon.CA <br /> 5002 Archer Street. Alvis ,CA 2430 Almond Dr. <br /> CAL 000 161 743: 95002 Silver SphNs,NV 89429 CAD 097 030 993; 90058 NET 10 DAYS <br /> (510)476-1740 NVO 982 358 483 (800)266-7747 <br /> (775)577-9001 _ r <br /> Pacific Recovery Resource O Seaport Environmental Re O Commercial Filler <br /> e; uniin:EEL CAD Pico 52 4 Los Angeles.CA 675 OX,14 Blvd: Redwood Clty,CA (510) Western Ave; Union City.CCAD 008 252 405; 90023 CAR 000 140624; 9408) (510)48]922]: 9d5&7 <br /> (650)364-8154 <br /> Del4enno Kerdoon (" Crosby&Overton ` <br /> 2000 N.Alameda Blvd. Compton.CAT 1630 W. 17th Street. Long Reach,CA <br /> CAT 080 013 352: 90222 GAD 028 409 019: 90183 <br /> (310)5374100 r <br /> rZ <br /> hereby CeNly that all information submihed in this and am attached documents contain true and accurate descriptions of the waste.All relevant iMormahon regarding known or sus ed hazards <br /> associated with the wastes has been disclosed I coney that we have an established program to reduce the volume of waste to the degree to be economically practicable. <br /> DRIVER GENERATOR <br /> SIGNATURE SIGNATURE <br />