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f <br />_ <br />OL—w1ALIFORNIh. <br />Ma;f Gca1• "40)Far�:erlt!o: IG"� �Y4IGH2J�l.Q-�}600 SMt T 4 AVENOL C71tFuatviA 04580 MANIFEST <br />i 481'*) e,, 2-528.4 . (800) THE MILS^ <br />EPA NO, CACI 360 (399,1761 <br />Al.t.A�tO: ar rrw E.�'„�on QrcVv or Ca+rco•+K>t <br />✓?ni.:eM� :� :hr t raM.l:en of nw fneey <br />nu+�raM �L <br />�c <br />DATE 18 f <br />-����1.•_i� PHONE i <br />GALS/88L5/ffTC. _-TPRICE AMOUNT <br />c7b <br />i 4Yk5T OIL$ CC•MBUST!5LE LIt?LfiA Nr�12?0^ =-r}-� - <br />EVERGREEN _�.. ._._-,.___•__.• ..._....r._....-----_, -1------ <br />Qo�1 <br />---..0 SMITH AYE. TOTAL ' <br />tvEV1AnK, CA ?;`.$0 04.0 W1587418 -"1" "- I <br />—PRIMENT qUf" 1 efjmrY TMT THETTf AAQ%l49H0'AN ASJ'.Z TO Ot C40RIG- ? A\C TART - <br />i1 n. ias OT_ 6E NOT'D, THE ►utEF?i V IS USCD or- 1 ► so T;�r <br />y N1 THcT I HAVE RGD THO CONDITIONS AND IND[I.Ati;f1�ATK1N6T." <br />IN <br />! fJ AY� RtvfR3£ SIDE Of TH13 ?,omm AND , UNOL"D ANO A;, CSI- TeOA <br />SioviATURE OF DRIVER. --" t �^ P ATURf ZNUtATOA <br />.� <br />I <br />■ <br />55:41 6861 'ZZ'S <br />9ZI046Z Sit W021d 03A1333ZJ <br />aymenr fp: OICE �� e�- f� o <br />'.. <br />lC,4LIFmallOcapRywN/thlpk1L REC [ CI.ERS INC. Ohl I� <br />BASO SMITH AVENUE . NEWARK, CALIFORNIA 84580 MANIFEST M�-1`'c�.•L; <br />(800) 572-5284 . (OILS <br />EPA NO. CAO lo <br />A .MGMb.. ct Ih. f-V-1feen Orour of comp—t-1 <br />,rte UwlcAt,d to rhe?rofw_tton of fu Environme:t <br />DATE <br />�f- PHONE <br />j4 <br />— ZIP _ GUST R - <br />_�^_ -- _MAT5AIAL---- 0AlB�Bel6/ETC. <br />- <br />WAS L OILS G7NIBUSTIBLE LIQUID NA1270 ' '�-- <br />7"oli <br />TSG:i <br />F. EYE�REEN UiL INC.�fT� % A}` i L/ <br />-83dt1 SMITH AVE. <br />FgVAR:(, CA 44580 CA7 980887418 <br />PRICE AMOUNT <br />1 <br />1 <br />TOTAL I, Q. ! 4 <br />1 CERTIFY THAT THE AMOINM SHOWN AaOvf TO 6E COnAECT AND THAT, <br />- UNLE98 OTHCAW+EE NOTED. THE MATERIAL 15 USM OIL 1 ALSO C" MFY <br />JAYMENT DUE THAT 1 Hs READ THE COND TI 6 ANO INOEMNIAICATiONS ON THE <br />fN 7 iJAYS Ra V�R9E f OF TM19 FOPM A 1 NDER9TAN0 AN7.�CGE� THEM <br />$1 C}KA7l.iaC �r DNiVER _--'"--'— 51QPIATU9E Of0 .ATOA <br />