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Z <br /> ✓ / <br /> Evergreen Environmental Services No 46350 <br /> Containerizedthe protection <br /> Services /� <br /> / Jechedulated to theickup,ica(?f the rnvirvn Sent <br /> To schedule a pickup, call Send payment to: Sal <br /> 800-596-9455 Evergreen Oil,Inc. <br /> 6880 Smith Ave.,Newark.CA EPA#CAD982413262 P.O.BOX 30217 <br /> 165411 3.Smi Pedro St..Carson,CA EPA#CAD982413262 Los Angeles,CA 90030-0517 Date: <br /> GHTORUOB LOCATION BILLING INFORMATION <br /> N NAME CASH Q CHECK Ej <br /> # <br /> BESS CUSTOMER CODE NO. <br /> CITY /STATE IP O. CITY STATE. ZIP CO. PO# <br /> y <br /> PHONE NO. PHONE.NO. PROFILE NO. CUSTOMER EPA ID NO. <br /> PRODUCT WASTE MANIFEST QUANTITY UNITS PRICE AMOUNT <br /> CODE NUMBER <br /> Waste Latex Paint(Non-RCRA) <br /> Waste Latex Paint(Non-RCRA) -. .. _ _.__ _ _ —_ _. _____— -_ -- - ___ <br /> il <br /> Waste Paint Related(Flammables oil based) <br /> Waste Paint Related(Flamnables oil based) <br /> Waste Aerosols Cans <br /> N RCRA 14 e 1 Wum.Solid 4S 1. <br /> l H <br /> RCmmineu W mkumh d,uuhons <br /> Ym-RRA au�doua Wv,e,Sulk($oil, <br /> n..an..mmminaw wia, oakum MxaMm. <br /> Waste Corrosive Liquids,n.o s. <br /> Waste Flammable Liquids,n.o.s. <br /> Waste Flammable Liquids,n.os. <br /> Non-RCRA Hazardous Waste,Liquid <br /> Non-RCRA Hazardous Waste,Liquid <br /> Waste Toxic Liquids or Solids(Class 9) <br /> Waste Oxidizing Liquids or Solids <br /> Drained Used Oil rs <br /> Empty Drums <br /> Non Hazardous Water <br /> Non Hazardous Water <br /> Non Hazardous Solids <br /> Non Hazardous Solids <br /> Glycol Bulk 50/50 <br /> Glycol Bulk Cone. <br /> TOTAL CHARGES <br /> TSDF <br /> ❑ Evergreen Oil,Inc. ❑ CFR ❑ <br /> 6880 Smith Ave. 33210 Western <br /> Newark,CA 94560 Union City,CA 94587 <br /> CAD980887418 CAL000091507 <br /> Source: Ll Collection Station Ll Government Generator Certifies that it has established a program to reduce the volurrle or <br /> quantity&toxicity of the hazardous waste to the degree determined by <br /> ❑ Marine ❑ Agricultural ❑ Industrial generator to be economically practicable. <br /> 1 hereby certify that I have read and have the authority to <br /> bind the above listed generator to the terms on the reverse <br /> Retain sample# side of this form. <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. <br /> Per California Health and Safety Code Section 25250.9,Evergreen hereby advises customer that customer's shipment of used oil may be <br /> transported to a facility that is required to comply with federal regulations applicable to management of used oil,but that is not required to <br /> comply with the more stringent requirements applicable to hazardous waste management facilities.California facilities that handle or process used <br /> oil are required to meet those more stringent requirements,and some out-of-state facilities that process used oil also meet those requirements. <br /> These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial assurances for <br /> closure and accidental releases. It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards <br /> and not these more stringent requirein nis.This notification is for information purposes only. <br />