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—a AIR Evergreen Environmental Services 2 69372 <br /> Contalnerized Services <br /> —�_ dedicated to the protection of the enviromnent <br /> — To schedule a pickup,call Send payment to: <br /> 800-596-9455 sa1E.s ordex <br /> 6880 Smith Ave.,New F-1 greeli Oi3-Inc.. 4 <br /> Newark,CA EPA <br /> CAD%2413262 L2 pt.LA 23234' <br /> 1G540 S.San Pedro St.,Carson,CA EPA#CAD982413262 <br /> GENERATOR/JO13 LOCATION Pasad ntt,CA 91385-3234 <br /> Batt. <br /> NAME RILLING INFORMATION <br /> C.,� NAME <br /> ADDRESS CASH El CHECK <br /> ADDRESS # <br /> CITY CUSTOMERODE NO. <br /> ZIP CO. CITY <br /> STATE ZIP CO. POW <br /> E <br /> •.ryo PHONE NO. PROFILE NO. <br /> ( ) CUSTOMER EPA ID NO. <br /> PRODUCT WASTE MANIFEST <br /> Waste Latex Paint(Non-RCRA) CODE NUMBER QUANTITY UNITS PRICk <br /> AMOUNT <br /> Waste Latex Paint(Non-RCRA) <br /> Waste Paint Related(Plammubles oil based) <br /> Waste Paint Related(Flartunab <br /> 1�'an7�tyasecij .._ p:, a an _ -;, iy'•ln <br /> Waste Aerosols Cans <br /> Non. CRA l+azallous waste•Solid(Boll, <br /> Debris ewmm�inuteU wiUt •trolenm h Una:arbons <br /> Nun-RCRA aw�Uous Waste,Swill(S 1, <br /> Debris conlmninweU witft tmlcut"It rortrbotw <br /> Waste Corrosive Liquids,it.o.s. <br /> Waste Flammable Liquids, o.a. <br /> Waste Flammable Liquids,n•o.s. <br /> Non-RCRA Hazardous Waste,Liqui <br /> Non-RCRA.Hazardous Waste,Liquid <br /> I Waste Toxic Liquids or Solids(Class 9) <br /> j Waste Oxidizing Liquids or Solids <br /> Drained Used Oil Filters <br /> Empty DrtmL <br /> Non Hazardous Water `�S m� <br /> Non Hazardous Water .®e) �Qo_mtj <br /> Non Hazardous Solids <br /> Non Hazardous Solids <br /> Glycol Bulk 50/50 <br /> 3 Glycol Bulk Cotic. <br /> I <br /> I <br /> TSD CA— <br /> Eve • n Oil,Inc. TOTAL CHARGES <br /> 6880SMI Recycling <br /> 94 <br /> Newark CA 56o USA <br /> C980741aion City,CA 94587 <br /> AD888 CAL00Q344530 <br /> Source: ® Collection Station <br /> ®Marine ®GOverilrnent Generator certifies that ithas established a program to reduce the volume or <br /> Q Agllculillral ❑� ilstlial quantity&toxicity of the hazardous waste to the legeee determined by <br /> generator to be economicaIl <br /> I bereby cerci y practicable, <br /> �.@tiZlll SBntlple# 1 —__ fv that I have rad and e. Ve the autl t to <br /> WC ove listed aPnerator to the+F <br /> IMPORTANT NOTICE, REG Nr N on theme <br /> Per CaUfoported to <br /> health and Safety Code Section 25250,9,13v ARDING THE DEPOSITION OF YQ <br /> UIZ OIL. <br /> transported to a facility that is required Evergreen hereby advises customer that customer's shipment of used oil may be <br /> eq u. to comply with federal regulations applicable to management of used oil,but that is not required to <br /> oil are-required to meet thowith the more se morent e stringent requirements,andand some Out-of-state ate <br /> management facilities.California facilities that handle or process used <br /> These include more stringent leak detection and prevention r <br /> closure and accidental releases.It is la facilities that process used oil also meet those requirements. <br /> and lawful to send used oil to out of-state facilities that t�mply only with federal used <br /> more s nt requirements.This notification is for information pure certifications of tank integrity,used <br /> and manage assurances for <br /> oil management standards <br /> IVIDriver Signature Print Nama n -_. . �' t <br />