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Evergreen Envi nr -ital Services N1 'c O rd e r <br /> dedic ated to the prate•tion r environment Bill of Lading WOC 9 6 6 81 <br /> To schedule a pick p, call Send Payment to: SACH 1 Q <br /> -••/� 800-972-5284 Evergreen Oil Inc Customer <br /> or 510-795-4 00 Dept.of LA 23234 <br /> 6880 Smith Ave., Newark,CA EPA#CAD 82413262 Pasadena,CA 91185-3234 <br /> 16540 S.San Pedro St.,Carson,CA EPA CAD982413262 <br /> Pickup Location: Bill To: <br /> SANBORN CHEVROLET SANBORN CHEVROLET <br /> 1210 SOUTH CHEROKEE LN 1210 S CHEROKEE LN <br /> LODI CA 95240 LODI CA 95240 <br /> Contact:RON FISHER (209)3345000 Ext.0000 <br /> NOTE <br /> CUST NO. — t� �r TiMS PURCHASE ORDER NUMBER 11TERRITORY <br /> REQ.DATE B E NO. Billgroup OI UTE PROFILE PROFILE P INTED BY <br /> 911312U12 Lilt lULMv <br /> Quantity Item Des ription Manifest No. Unit Price Amount <br /> Req. Picku r <br /> a.00 1L CAL11141111 B>2MB B / $0.00 Contract <br /> 1.00 5G POLY ODYN DR $0.00 C OnlraCt <br /> z.o0 13 hORSC L1G /TUB YB C <br /> $0.00 C oniract <br /> i <br /> ALKALINE MIIif ERIES AND FLUORESCENT TUBES. BRING 41 <br /> B FOOT BOXE . <br /> TSDF ❑Como 'dated Manifest DRIVER CHECKLIST <br /> ❑Evergreen(.)it.Inc. ❑Evergreen oil.Inc.-DavisEverereln oil.inc.-Fresno Time la Timeom <br /> 6880 Smith At . Road 30B 4139 N.Valentine ❑TanluDmm Properly Labeled <br /> Newark.CA 94560 Davis.CA 95616 Fresno.CA 93722 ❑Accumulation Start Cate Marked <br /> CAD980887418 CAD982446874 CAD982446882 ` f- /y// House peeping-TanklDrum Clean <br /> ❑Ever_reen I:m.S c.❑Evergreen Oil.Inc•Santa Nana SA Recycling F1 Test Results fD Other Services Checked:❑Oil.❑FBerslDmms.❑Antilreeze <br /> 1660-1S; NJ- 7115;\West Better,ia 33210Western PPM 0 Called in other services needed❑Oil.❑FittersrDmms.❑Antilreeze <br /> C ar,on.CA 90746 Santa iMaria.CA 93454 1lnion City.CA 94587 <br /> CAD981696420 CA D982446858 C.AL000344530 <br /> Generator certifies that it has established a program to reduce the volume or <br /> Source' ❑Collection Station Government quantity&toxicity of the hazardous waste to the degree determined by <br /> generator to he economically practicable. <br /> ❑Marine ❑Agricult iral ❑ Industrial I herebycertify that I have read and have the authority <br /> to bind the above listed generator to the terms on the <br /> Retain Sample#-- reverse side of this foem. <br /> IMPO ZTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. <br /> Per California Health and Safety Code Sect on 25250.9,Evergreen hereby advises customer that customer's shipment of used oil may be transported to a facility <br /> that is required to comply with federal regulati ns applicable to management of used oil,but that is not required to comply with the more stringent requirements <br /> applicable to hazardous waste management fa ilities.California facilities that handle or process used oil are required to meet those more stringent requirements,and <br /> some outCIFrics rocevs used o I also meet those requirements.These include more stringent leak detection and prevention requirements,engineering <br /> cert' Ions of tank integrity.• d financial as urances for closure and accidental releases.It is lawful to used o' o out-of-state facilities that comply only <br /> v federal used oil manage ent ,t• rds at these more stringent requirements.This notificat. is r in m' Ion tposes only. <br /> r" <br /> v <br /> Driver Signat rint me Route# Date Gen ator's Signature Print Name Date <br />