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WE ACCEPT � .—A & MASTERCARD <br /> CLEARWATER <br /> ENVIRONMENTAL MANAGEMENT, INC. <br /> BIII Of Lading <br /> REMIT TO: <br /> PO-Box 2407 UNION CITY,CA 94587-2407 P.O. Box 349 SILVER SPRINGS, NV 89429-0349 Invoice# 105190 <br /> (800)499-3676 FAX(510)476-1786 (775)577-9001 FAX(775)577-9199 <br /> CAR 000 007 013 NVD 982 358 483 (800)471-2105 Dat 2" -O <br /> BILLING INFORMATION JOB SITE <br /> NAME NAME PO# CASH CHECK <br /> Ll <br /> ADDRESS `4S AD SS '.' J CUSTOMER EPAID# <br /> —r-70elj LW Cup S7: L <br /> CITY STATE ZIPCITY STATE ZIP PR FILE# <br /> 2 <br /> PHONE NO. PHONE N0. CUSTOMER ID NO: <br /> ( ) <br /> PRODUCT PROPER WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> SHIPPING DESCRIPTION CODE <br /> Used Oil, Non-RCRA Hazardous <br /> Waste, Liquid 221 <br /> Used Automotive Antifreeze, Non-RCRA <br /> Hazardous Waste, Liquid 134 <br /> Oily Water Non RCRA Hazardous <br /> Waste Liquid <br /> Non RCRA Hazardous Waste Solid <br /> Oil Contaminated Debris/Soil <br /> Waste Combustible Liquid nos 3 <br /> UN1993, PG III <br /> Non Hazardous Waste Liquid <br /> Non Hazardous Waste Solid <br /> Transportation Charges <br /> Washout Charges <br /> Drained Used Oil Filters <br /> Empty Drums <br /> Additional Labor <br /> Pressure Washer <br /> Other: <br /> DISPOSAURECYCLING FACILITY: CollectionSlalion Industrial Agriculture Government Marine TOTAL <br /> AIVisd Independent Oil O avensetar Environmental Mgmt Inc. DM EtwhOnmestal ) <br /> 5002 Archer SireeY. AlAm CA 2430--u Or. W%E.26th Street:Vernon.CA <br /> CAL000161743: 95002 Silver Springs,NV 69429 CATOW033681; 90023 NET IO DAYS <br /> (510)4761740 NVD 902 380 483 (323)268,5056 <br /> (n5)M-9001 <br /> Onyx EnWronmental Servkes O Seaport Emiranno.old ommernal Filter Recycling <br /> 1125 Hensley Slreet: Richmond.CA 675 Seaport Blvd; Red1wood Cttg CA4�� }\��/WP I O Westem Ave; Union Ctry.CA <br /> CAT OW M W; 94801 CAR 000140 624; 94063 10)480-92]7; 94807 <br /> (510)233.8001 (M)364-8I54 <br /> DeMenno l erdoon Evergreen Oil <br /> 2000 N.Alameda Blvd: Compton,CA 6080 Smnh Ave; Newark,CA <br /> CAT0130013352: 90222 CAD9WW7418: 94560 <br /> (310)53-7100 (510)795-0480 <br /> I hereby cerfily that all irdarmation submitted in this and all attached documents contain tme and accurate descriptions of the waste. All relevant information regarding known or suspected hazards <br /> associated wt w tes has been disclosed.I certify that we have an established program to reduce the volume of waste to the degree to be economics pr cae <br /> DRIVER GENERATOR o <br /> SIGNATUR J�c��s SIGNATURE if iF <br />