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I <br />kkYY� ` 77S0 <br />GREENLEAF cNVIkO1Q Y�TAIt,j�,�Rq&ES BILL OF La DING # HT12014 <br />P.O. BOY. 1765 EPA NUMBER CAL000214411 <br />LODI, CA. 95�1s��76.6 PM x:45 <br />(209) 754-46 ill <br />JLF.I u.lY v.�;IW.YI' Mit'JL:L`J.Ylll' •N�: Ytr:YfJWPL-n rvN. <br />PICK—UP SHIP TO ', DATE <br />'iWyX iiWtll.v 1.:. JI: ._[.141 T' :.r'i IOY 4L�IYM1XYtJ16 It Y'1:I ylJ 1pCl'J YY'YXCICYe]Mn4JI I tlaNl Flv � v. , l„Y: ry1M19'. <br />C NAME 'CUST NO <br />U FFOCTHILL LANDFILL *GREENLEAF ENV. SERV <br />S ," <br />a TADDRESSTERMS <br />0 #6484 WAVERLf ROAD 3474 TOYON CIRCLE <br />t M;: <br />.: J:: .6.16. ,« JI .�. r' .,L, :•. <br />E CTCY <br />RE. ,U CA <br />952g�STATE ZIP lfVAL�EY SPRINGS CA PHONE <br />d 7 Zvi <br />1 <br />, <br />/6, z 'r CUSTOMERS PO# <br />�6MI M�.,, J.:: .��;'. , ✓::: I �?��'17L�NSCItI'.J6'.'LJM'„1�9�.i�4tillilikW3YMI,�L.YN1411 �: 21'JN;w,1111(L.^IfR'A3u'!urJ:rN51TeI.1i51E1ClJe'w a4151`'+�M�":puBtikM,..-01tlL .dd�IE!$".;4:c!*:r;Y'i;. <br />PRODUC yay,W, PRICE LAMOUNT <br />;� �DRAI' 55 GIL DR Wlll) r �L <br />NEL I' E. OIC �'iLTERS ���MyXI ryTyyr 45 00 <br />q1 : v.Y ,:.:Y: 1 1 'Y'.r � 5YL 1; INLYOY I Y �uv i Xulll 41 IASY rCl; 1 W J111 .Wy6Yf2'J;.",tlaYllYlyl 4 WJiIWY <br />_OIL Ali JI 6.._ h I i ALX . yyq <br />nv I.:uzlwttrm n f!x mase ex Xvcu lx:;: YitlLTEY t J¢•r a 4J sJ.o <br />aFP 1 ` <br />� <br />,1 I r,nl .'. Ic xuulY'; ¢MYrcm <br />1 <br />�SC. EMPTY DRUM ;,CRAP METAL <br />M I <br />... :.:.. .'.. LLI�:::. I �1' I'44 f..t"f n :.;•!.. J.W.Mh. i':::r: Y'MS.tl W&.i...:r.:!rpJ '. <br />jMTY EMPTY DRUM PLASTIC, <br />'DROP CUST bKUMS NEW ACCOUNT <br />1 <br />�v. .:irrXll!IJlfl �. :..i:l!i. vY.�YC •. i �. <br />'--CRU 'HED UNCRUSHED EMP f f <br />' • s . I'.'- a .NtCii vl viLCCYI�Y:!l^'J 4 Ya�IXI I I:IYIIC' <br />a <br />k I <br />eu. <br />;;«.b.J.u".,IC:a'JrA.Mu.s1Y..Y'-0tl;�9�l p.C.JdLJYilik:,;ll:.";,.rMIi1�L1w'15 kir.:.�J'AI.IN.;:;ie <br />TOTAL _ <br />CHARGES <br />I CERTIFY THAT THE INFORMATION AND THE AMOUNTS SHOWN ABOVE ARE TRUE AND <br />CORRECT, AND THAT THE USED OIL. FILTERS PROVIDED TO GREENLEAF ENVIRO SERV <br />MEETS THE DEFINITION OF USED OIL FILTERS PURSUANT TO CALIFORNIA HEALTH <br />AND SAFETY CODE SECTION 252.50.1, UNLESS OTHERWISE NOTED, THIS FURTHER <br />SERVES AS NOTIFICATION THAT THE ABOVE WASTE IS BANNED FROM LAND DISPOSAL <br />PERSUANT TO SECTION 66268.7 (10) OF TITLE 22. I ALSO ACKNOWLEDGE THAT I <br />HAVE READ AND AGREE TO THE TERMS AND CONDITIONS SET FORTH Oil THIS FORM. <br />_ ., �.. r_ iu yew' Lu rXx• arrr6 a:. L_:n 6 .,._... <br />DRIVERS SIGNATURE DATE <br />GENERATOR'S SIGNATURE DATE <br />