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FREMOUW E, .VIRONMENTAL SORVICES, INC. Send Payment to: Phone: 800-559-3274 EPA ID#CAR000171017 6940.1•remont Road Phone: 707448-3700 U.S.D.O.T.#1484667 INVOICE # 064813 Dixon,CA 95620 Fax: 707-448-3499 D.T.S.C.#3544 wxN,�N-.harardotisLlislunal.net CA#274461 Date SITE ADDRESS BILLING/AAAILING ADDRESS Customer Intern-ational Pam Tracy Sq( Customer 44 tU Valpim Road BILL OF LADINGAT i to :tis P;Ayahie APR 2 5 2016 Tracy, CA 95370 Pd Box 396 Milford, OH 45150 E.P.A. # CA (1100 .381467 - -- Phone Additional Contacts: ACI, ^209) fi36-6181 PAYMENT TERMS: NET 15 that: �In ; PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION 7 • 14 • 21 • 30 • 45 60 • 90 • 180 • 365 W/C WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT CODE - SERVICES REQUESTED BY TAX cc Ae t =�W— P.O.# TOTAL CHARGES: GENERATOR'S CERTIFICATION: I herebv declare that the contents of this consignment are hdry and accu,arely described above by proper shippmp nome ano amciccsited.pa k- labeled,and are in nil resue:ls in proper condition for transport by highway according to applicable Mate and national government regular ns. 'f i am a,urge auar t'ty generator I cert 1y ., have a program in place to reduce the volume and toxlcfN of waste generated to the cieg,ee I have determined to be economically practicable and that I have selected the practicable mem:Irl of treatment.storage,or disposal currenf�y available to me which minimized the present and future threat to human health and the environment.OR.if I am a small quantity generator.I have mnue a good faith Owl to minimize my waste generation and seied the best waste management method that is ovallable to me and that I con afford. All used oil from the generator listed above will be transported only to a facility permuted by the State of Ca9fomia to produce used oil Into recycled oil OR a facility that is required to comply with Federal regulations applicable to the management of used oil. All relevant information regarding known or suspected hazards associated with this waste has been disclosed. The customer agrees to pay reasonable costs and attom• tees incurred in the collection of this obligation. Venue for ses of this obligation shall be in Solana county. I declare under penaltyof r u that the for um is true and correct DISPOSAL/RECYCLING FACILITY: Collection Station Industrial Apriculivre Government Marine Other industrial Lubricating Print Name Generator's Signature Drivers Slgnature I hereby certify that I have read and have the authority to bind the above listed generator to the terms on the reverse side of this form. F 1 n -Rev.02,1.1 State Law Requires that you keep this Receipt/Bill of Lading on file no less than 3 years.