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--W1-W to schecluis,a pickup, ca.,! �eflcl plyynent try: S,'Jtn 011011 <br /> 7 <br /> 800-596-9.V E.ver&feen Oil, Inc. • <br /> -------- <br /> 61,80 Smith Ave,,Nmarl-CA FTA#CAF)9924 .1762 P.O.13OX 30217 <br /> S. Pedro St.,Cau&011,CA <br /> 1040 EPA#CAD9824 f 3-62 Los Angeles,CA 90030-0517 Date: <br /> NERATOR/JOB LOCATION BILLING INFORNUMON <br /> NAMP, <br /> # <br /> I-AD ADDRESS C <br /> S�� I'1�7 CO- <br /> CITY <br /> MPHONE NO. PROIZILE NO. ""'0 ER EM'5t N7)4?ff <br /> ON7WYIE3-5�- 7A� <br /> WAS'FE <br /> PRODUCT CODE NUMBER QUANTITY UNITS PRICE AMOUNT <br /> Wasm Latex Paint(Non-RCRA) <br /> Waste latex Paint(Non-RCRA) <br /> Waste Paint Related(Plananabits oil based) <br /> Waste Paint Refuted(Flunnoublos oil based) <br /> Waste Aerosols Cans <br /> NIPA-RCRA Jbmu.'Ww'Witt <br /> 1..duft <br /> Vv`a4v:Corrosiye'Liqaida,rims, <br /> Waste Flan7ntabde Liquids,n.o.s. <br /> Waste lebutrarible Liquids,n.o.s. <br /> Non-RCRA Hazardous Waste,Liquid <br /> Non-RCRA I Lyzardous Waste,Liquid <br /> Waste Toxic Liquids or Solids(Class 9) <br /> Wasla Oxidizing Liquids or Solids <br /> Drained Used Oil Fifters <br /> Empty Don <br /> Non"Wa dous Water <br /> INen.Hazardous Solids e <br /> Non Hazardous Solid, <br /> 0 lycol Bulk 50130 <br /> I 'lycollfulkConc. <br /> 1 6-51 <br /> TOTAL CH ARGES <br /> TSDF <br /> 1--'vergreen Oil,Inc. CFR <br /> 6880 A <br /> SmithAve. 33210 Weslerol <br /> Nv,A ark.CA 94560 Union <br /> !, <br /> "itv CA 94W+�-4� <br /> CAD980.937418 CAUX' <br /> ne.torcer! that it has establiihed a jacgrann to reduce the volatile or <br /> 1150' fq� <br /> Source: j Collection Station Lj GovAKent <br /> quantity&toxicity of the heoandous waste to the degree detennined by <br /> generator to be economically practicable, <br /> Marine U Agricultural Indusuial I-bareb.3L-ceffift-that I have read and have the authority <br /> bind the abon listed tor a nj n the <br /> Retain sample# Ade Iff th is-form. mgMg I M___L_IheteLL _q__ I opygIM <br /> IMPORTANTNOTICE REGARDING THF..DISPOSITION OF YOUR OH- <br /> Per California Health and Safety Code Section 25250.9,Evergreen hereby advises customer that customer'sshipmerutof used oil may be <br /> transporter] to it 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 MqUil-CA 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 p9mTernents.This notification,is for information purposes o3111. <br /> 7rs Print <br /> —--- --- ----- ------- <br /> 45 <br /> --- - <br /> Driver I it,ane Route Date eneratorZs S1 <br /> gnatu e Print Name Date <br />