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Evergreen Enviro•ental Ser.vices H° 16 317 <br /> a Conw pivi ized Services p <br /> deriirared to rlw prvrrerriun of IGC rnHirnnrnrm /,�� J <br /> To schedule a pickup, call Send payment to: Sales Orde4 #'_ <br /> 800-596-9455 rver,recn Oil,Inc. / <br /> t!OW Smith Am, Newark,CA EPAO CAO6,824132e2 Y.O. BOX 30517 <br /> 165Ao 5,Sun Pedro St.,Car An,CA EPA9 CAO91124132eR Los Angeles.CA 9ll030-0517 Dat/ef <br /> GENNRATOO41j B LOCATION BILLING INFORMAryy���p�/N/—J —T�.ASH❑CHECR[1 <br /> ADDRESS u Wpo"t <br /> AUUCl'I'VE. %lr Co C1TYS'fATg Z1P CO- <br /> P NE ). --TFfONF..NO. PROFILti NO. C r _�SPiI '� t) <br /> - �.._ I <br /> I (-W':il"I"T MANIFFS'1' AL N'1•ITYTi!NI'f5 PRICE <br /> PRODUCT �MOUN'T <br /> CODF. .NUMBER l .{ <br /> 4W;pte Latex 1>11 lit LNan•RCRA) <br /> VV .- <br /> Waslc Latex Yaim(Non-RC'RAI l .. l �-.. <br /> Waste Yuittt Related(1°Imnmubtes ml haeclll_ i _�_„ � -- - <br /> Wasle Paint Milli(Flammable.,vi! hau:d)_ ... . . ...' . . -_. - ... <br /> Waste Aenrsals Cans .... ... .... . <br /> . .--RA 11uwMuu.x air.4uiJ ltioa. .. .. - _- <br /> IMcHfW, <br /> Inaxi.•YmyV ^.n.:A x<lL amJepra n..l,,....lx.ui .... ._ �� �__._�"'. <br /> .� 1\1 Ic Corrosive Ulplids.n.as. .... .._ .... -- - <br /> �R'Jsle 19:nnnroblc Liquid.. il.u.n. �... .. .. <br /> i. .. <br /> Wa,,Fl:unmablr} , n,as. <br /> IRCRA Hazan!uu>Wave.Liquid <br /> jNnn-RCRA IWardou>yy4sw,Liquid <br /> l Wasta Toxic Li!4:ids or Solid,IC.lan,9! it <br /> f�Wastd.Qxidixmr Liquids nr Snlidz . . .. I --.•^, � _..... - <br /> 1)rI .uucdUsal r/il •drer5 � "-_�. -. ..I .� _ <br /> limply Drums ..... ... .. . .. ^f <br /> Nn m 'Us S:dids ..._._.�—_....�-- �� .. <br /> INon Huzardnux Solids <br /> C➢lycul Bulk RIPS- <br /> TQTAL CHARGES <br /> TSDF I� <br /> ,111= Li ,tgnn'n Oil.Inc. I ' CFR F-1 <br /> I <br /> %4d Wo Smith.Avc. •-� 332111 Western . <br /> Newark.CA 94560 1 mol!Cit...C.A 4459? —__ .. L <br /> _ CAD99(hM741a C.AL(H)!IlP)1>117 ...._ <br /> -•�- "" -� (ieneralur a�rtificn that it L•ea+aahlished a p+rlrram al redum the vn!ume or <br /> j Source.: I)Collection S[at.ion 0 Governiilcrit I qunnliry x toxicity nr the hayardnus waste a:Ihv!icgrec dcicm:ined by <br /> J <br /> Marine T-1 Agricultural ❑ industrial <br /> g.mm�lnr to tx a:pnnmicerly pnluicahlc. <br /> �- .?«..__ .._. I hembv cet'[ifY that I have ygyd and have the aathnrib to <br /> bind the above listed t(.geratur to the terms on the ruverae <br /> Retain sainple # — aide ot'th s fanll <br /> INIK)WI ANT NOTICE REGARDING THF. DISPOSITION OF YOUR OIL. <br /> Per California licalth and Safety Code Section 25250.9.Everprucn hcml)v advises customer that cualnmcr'l .hiproent of used oil may be <br /> transponed in a facility that is required W comply With federal reguicdions:yrplicabic 1n managelncm u1'used oilbut that is 1101 inquired t0 <br /> comply with the more stringcm requirement-applicable Io hnaardouR waste mallnge.tnenl facilities. California fuQi.lities that handic or process used <br /> vil arc lrgnired to meet thlwe r,:ore stringcm mqulremcn!s. and sonic but-ser-stare fucili!iea that process used oil also meet those requirements. <br /> These include more stringent leak detcotinn and prevention requirements, eniinecrin1;eniticationx 1d look ino:gnry, and financial assurances for <br /> closure mrd aceldentul releasci. It 1s lawful to Rend used oil In nm-of•stale facilities that comply nnly with fcJcral used oil management standards <br /> and nol these more stringent reyuilvMcnls'. Chia nutifiefltino is fen,intonnation purpot,ct,only. ` <br /> - - _ <br /> M« (;!•nrratnr'c .Cian:anrr Pt'1nt Name Dine <br /> ZOO/LOGIA XVj LL SL i00Z/50/ll <br />