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FREMOUW EVIRONMENTAL SWtY10ESq INC* <br />Send Payment to: Phon6: 800-559 1 EPA M # CAR000171017 <br />P.O. Box 2875 Phqne: 707-448-3 00 U.S.D.O.T. # 1484667 INVOICE #34449 <br />Vacaville, Ca 95696-2875 flax: 707-448-3499 D.T.S.C. # 3544 7 -- (� r <br />www.hazwasteremoval,com CA # 274461 Date <br />SITE ADDRESS BILLING/MAILING A RISS <br />(tomer <br />Rambus Engine & Transmission At Engine & Transmission <br />Customer __.._..__.. _...__ <br />1031 E. Church Street 1031 E. Church Street <br />Stockton, CA 95205 Stockton, CA 95205 <br />E.P.A. CAL 000 333 868 Phone <br />Additional Contacts: 209-463-9046 209941997 <br />Bemeaf Mehhrag <br />PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br />7 • 14 • 21 • 30 a 45 • 60 • 90 • 180 • 365 W/C WASTE <br />CODE <br />MANIFEST NUMBER <br />QUANTITY <br />UNITS <br />PRICE <br />AMOUNT <br />)ogled Used Oil ! Gascim 1 Diesel Filters WA <br />P n ame <br />�ettRCRA wr.nta sftste sold (alCon* tdedDebft solo CA 223 <br />- <br />7 -e <br />I hereby Certify <br />that i have read pnd hove the out <br />E�scktded Recyclable Mattel (Latex Paint) WA <br />+haste Pent Relaled Mate K 3, PGI( LWI, 331 <br />JNIV03 W" Ftlt tmobla Muds RO.s. t, 33t <br />`ion-RCRA Hazardous 11'Vtaate Liquid (Braise Fluid) CA 343 <br />*Ste AeOS* FAMpol meviN IL c4)will 1, LTN19W - 'SIA)001 <br />.NIYERSAL WASTE <br />;NTIbustM Uqud, N.O.S., NAW, III (Haktgen8ted 01) 411F002 <br />Jet CRA ria waste LXX I01y S;Wpel A 349 <br />0, ,'/ 16-Z �'-5-k, <br />.�' S <br />.4 Truck TitoferRemal�al <br />Empty Drums Provide Remove_[::]_ 1 Al( I g 0 10g 0 15g 0 30g O 55 P F <br />`i .� <br />�j 773.<7.) <br />Clor-D-Tett Q4000 Test Kit: Test 0 Pass 0 Fail 0 Generator Knowledge 0 PPM <br />Transportation Charges/Additional Truck Time/Additional Labor/ LAB Packing/Site Cleaning <br />Clean: Y N <br />Labels <br />Oil <br />A/F <br />UOFOily <br />Debris <br />SERVICES REQUESTED BY <br />TAX <br />q770 <br />We = 63 is <br />Accept <br />P. O. #k TOTAL CHARGES: <br />S - O <br />GENERATOR'S CERTIFICATION: I hereby declare that the contents of Ihas consignment are tu'ly and accurately described above by proper shipping name and are classified, pocked. marked, and <br />labeled. and are in di respects in proper candalon for transport by highway according 10 oppl Coble state and notiond government regulations. if I am a large eranfity goneralor, I certify thal I <br />have a program In place to redur-r the volume and IoY city of wase generated to the degree I have deferr fined to be economically practicable and that I have selected the practicable method <br />of treatmen±. storage, or disposal. currently ovoilobie to me which minimized the present and future threat to human health and the enyrcanment; OR, it I am a small quantity generator, I have made <br />a good faith etta7 to minimize my waste generation and se!ect the best waste management method that is ova:able to me and that I can afford. All usea ell from the ganeralor listed above <br />will be transported only to o facility permuted by the Stote of caftrna to produce used oil Into recycled of OR o tacitly that is required to comply with Federal regulations opp7coble to Ilse <br />marogement of used oil. All re'evarsl information regarding knuwr, or suspecied hazards associated with rh wwty has been disclosed. The customer agrees to pay reasonable costs end attorney <br />fees incurred in the collect!on of this ob5ga`ion. Venue for purposes at this obligation shall be in Solana county. I declare under penalty et perjury thol the forgoing is true and cerrecL_ <br />❑ISPOSAVRECYCLING FACILITY: I C011ection Station I Industrial I Agriculture I Government I Marine I other I ma"a"' I 1V6foN <br />10218l,rtcWrtn,d <br />441y Rdd30e <br />t 8rJoee. U ffiiV <br />2 DIM clifV6 18 <br />41"1Ooi52 CJDOr8i"M 610TBSgOD CADSOW1174 <br />h <br />P n ame <br />- <br />7 -e <br />I hereby Certify <br />that i have read pnd hove the out <br />t0Wwwa•w,dra,w <br />5 N rbft RR r?r+5 <br />501 7M80 !IlYia1111CA r0 <br />,v{.: ti <br />i_ <br />401W cizilietRind trll;�wrreFLcknue <br />e+!mu• cA t» 5 I F, Rserlb P, OM, CA 99r2 <br />510.5{1-2115 C111.mO7W/3! 916361aw C,1Dt t$tlCi <br />Drivels SIanat re <br />r►rotor to rho torms_on tins reverse side .gf this Form <br />State I ow Requires phot you keen this Receiotlaill of Ladino on role no less than 3 years. <br />