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r _ WE ACCEPT „fSA& MASTERCARD <br /> -CLEARWATER__ <br /> ENVIRONMENT <br />_ AL MANAGEMENT, INC. 4*do <br /> REMIT TO: Bill of Lading <br /> P.O. Box 2407 UNION CITY, CA 94587-2407 P.O. Box 349 SILVER SPRINGS, NV 89429-0349 Invoice # 115821 <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 <br /> Date <br /> BILLING INFORMATION JOB SITE <br /> NAM EADDREESS <br /> PO# CASH CHECK <br /> ADD S <br /> CUSTOMER EPA ID# <br /> CITY STATE ZIP CITY E <br /> / / STATE ZIP PROFILE# <br /> y`�-� GAF (:; <br /> PHONO. p PHONE NO. CUSTOMER ID# <br /> PRODUCT PROPER WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> SHIPPING DESCRIPTION CODE <br /> Used Oil, Non-RCRA Hazardous <br /> Waste, Liquid 221 O <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 /> ti <br /> DISPOSAL/RECYCLING FACILITY: Collection Station Industrial Agriculture Government Marine TOTAL <br /> f <br /> Iviso Independent Oil Clearwater Environmental Mgmt.Inc. O D/K Environmental <br /> 5002 Archer Street; Alviso,CA 2430 Almond Dr. 3650 E.26th Street; Vernon,CA <br /> CAL 000 161 743; 95002 Silver Springs,NV 89429 CAT 080 033 681; 90023 <br /> (510)476-1740 NVD 982 358 483 (323)268-5056 NET 10 DAYS <br /> (775)577-9001 <br /> Onyx Environmental Services Seaport Environmental �J Commercial Filter Recycling <br /> 1125 Hensley Street; Richmond,CA 675 Seaport Blvd; Redwood City,CA 33210 Western Ave; Union City,CA <br /> CAT 080 022 148; 94801 CAR 000 140 624; 94063 (510)487-9227; 94587 <br /> (510)233-8001 (650)364-8154 <br /> DeMenno Kerdoon Evergreen Oil <br /> 2000 N.Alameda Blvd; Compton,CA 6880 Smith Ave; Newark,CA <br /> CAT 080 013 352; 90222 CAD 980 887 418; 94560 <br /> (310)537-7100 (510)795-4400 <br /> I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of the waste.All rete nt information regarding known or suspected hazards <br /> associated with the wastes has been disclosed.I certify that we have an esta ogram to reduce the volume of waste to the degree to economically practic <br /> DRIVER GENERATOR <br /> SIGNATURE �, SIGNATURE <br />