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03/07/2013 14:58 FAX 12094658060 BULKSTOCKTON@BULK-DTI.CO 10004/0006 <br /> vergreen Environmental Services <br /> N° & I1 3 <br /> i <br /> Containerized Services <br /> dedicated to the protection of the environment �i <br /> To schedule a pickup, call Send payment to: Sales Order# <br /> 800-596-9455 Evergreen Oil,Inc. <br /> FiNBCi ! e,;Newark,CA 13PA#CAD982413262 Dept.LA 23234 <br /> 16'54; edro'SC,Carson,CA FPA#CA D9824t3262 Pasadena;CA.91185-3234 Date: <br /> GE11, OR/JOB-LOCATION BILLING:ITQFORMATION <br /> IN_ NAME CASH[]C ICII;El <br /> - <br /> j .� # r: <br /> D ll" ADDRESS CUSTOMER DE NO. <br /> CI STATE Zirp CO. CITY STATE ZIP CO. <br /> QZ r <br /> PHO ' _ PHONE NO. PROFILE NO. <br /> CUST ER <br /> NO. <br /> ( ) re <br /> PRODUCT WASTE MANIFEST <br /> ," CODE NUMBER QUANTITY UNITS PRICE AM ( „11 <br /> Waste` 1°aint(Non-RCRA) , . <br /> i <br /> Waste int(Non-RCRA) <br /> Waste ff§41med(Flarr mables oil based) <br /> Waste, lated(Flammables oil based) j p <br /> Waste ! Cans <br /> ..NM. c s wits c.solid(soil <br /> CXbds" with hokum h emcacbaa <br /> NUn•Rq )V.e,Solid(Soil, <br /> Dehris ith Iwm h dmeacbons <br /> Waste. a Liquids,n.o.s. <br /> i <br /> Waste kle Liquids,n.o.s. I <br /> I Waste El Ie Liquids,n.o.s. <br /> Non-RC ardous Waste,Liquid I' ! <br /> li Non-I. I �zardous Waste,Liquid <br /> waste. 'Liquids or Solids(Class 9) i <br /> Waste i 0�g Liquids or Solids p <br /> Drainel3 i, '1 Filters ! <br /> it <br /> Empty0l ( P <br /> Non H�a,'t Water { <br /> Non H z' 141 <br /> Water <br /> l <br /> Non Hoz tl Solids <br /> Non Hinz Solids t <br /> Glycol BNOOO <br /> I.. <br /> Glycol nc. <br /> i E <br /> TOTAL C ARLES <br /> TSD p I <br /> I1 <br /> Evi i)il,Inc. SA Recyclin l I <br /> 68' tIl Ave. Western ❑ I <br /> N }k 94560 Union City.CA 94587 i a <br /> C 17418 CALfl00344530 <br /> Generator certifies that ihas established a program to reduce a %ol me or <br /> 5our� Collection Station ❑Govemment quantity&toxicity of thq hazardous waste to the degree deter" n d <br /> Marine 0 Agricultural Industrial generator to be economically practicable, a l <br /> j IILbgEe v v at-Lb-averead.and have the ai to <br /> °. <br /> bind the aboye listed generatorth ,. rH <br /> I <br /> Retai nple# side of this form, <br /> i IMPORTANT NOTICE REGARDING THE DISPOSITION qF YOUR OIL. Ir <br /> er Cal ealth and Safety Code Section 25250.9,Evergreen hereby advises customer that customer's shipment of used ` ill a.;be <br /> ransport icility that is required to comply with federal regulations applicable to management of used oil,but that is not req ir to <br /> omply wi ore stringent requirements applicable to hazardous waste management facilities.California facilities that handle tess used <br /> l are req meet those more stringent requirements,and some out-of-state facilities th't pro ss used oil also meet those r i encs. <br /> hese Int.1 re strin ent leak detection and_prevention-requirements,engineering certtfic tionssof tank iVgrity,and financial' ti .races for ` <br /> lo.ui c a n a re ease . wful to send used oil to oat-of-state faculties that comp r , p y only with federal used oil manage erpt standards <br /> J tll:s e stringent requi ents.Thi. otification is for informationpurposes only. <br />