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MAY.15.2002 1:21PM CAL/FPA DTSC — HWMP NO.971 P.6i13
<br />31mo of Cglllamlo—nrlronmanrol Protection Aoenry 50o In�truetrona on back of G 0 6. of Ta
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<br />Form Apprond OMB No. 2050-003F feel Iran 9JOAdj P �}
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<br />1. Oeneraror'e US EPA iD No. Atanlfatf Document No. 2. Pago 1 Inlormallon in the shaded areae
<br />UNIFORM HAZARDOUS to not required by Federal law,
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<br />S. Transporter 1 Company ame e. US EPA ID Number t" Afq( JPpnspDAor'iJQ.":C?.;,.,, • I� ,t �bJ'r� J�,t' Spm
<br />°? EVERGREEN ENVIR NMENTAL SERVICES "�`"'ti'`I
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<br />0. US EPA ID Number E; B tete (0111 P.f'IQ a ;+• , e%;s r.. f:r
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<br />EVERGREEN OIL, INC. } a I .p, r. .� � �i:'1 '"r',k ,�-�'_�'.�,.-., �.
<br />6880 Smith Avenue . r �� ;` ,aI"�-,. :,..,,,,•9i „1 '- �;•
<br />%—I Newark, CA 94580C A Q7141118
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<br />O 15. Special Ha,ldllap hlttry ions and Acldliforud Infommatlan y
<br />24 Hour P'ar'g Response Telephone No.: CHEMTREC 1.800.424.9300 Invaloe I
<br />W DOT ERG 171 WEAR PROTECTIVE EQUIPMENT Sales Order # /- ,-5 -2 5/77
<br />IA. GRWEIIATOR'S CCRT11 IGTIONt I hereby declares that the conicnh o This consignment aro fully and accurately dotcrlba4! aboro by proper shipping name and aro clanlflad,
<br />•t ked, marts d by highway according to applicable Intarnationol and rtailonal gavomrnont ragulallont,
<br />U pee ad, and I belod, and ore in all repast'* In proper tondilian for Iranepo
<br />If I am a large quantlir agncroaor, I certify that I havo o program In place to reduce ileo .tslumo and taxlclry of waste generaled to Iho dogma I haw detenmlmd to t
<br />economically prookabl and rhol I here safacfnd rho proalcabia method of irooemomi, slomgo, or dbposol currently avollable to me which minimhes she prownl and furul
<br />`tr'I threat to human heahh and the erwlronnnnit Oft, it I am a (mall gwnliry asnoratar, I hove,f'ladc a g d lalth effort to minlmlto my waste ganomfian and icleet the bo
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<br />Witty mom sment memod that It Orallable m me and that I can afford.
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<br />7u5 17. Tram arter 1 Acknow1odcamunt of R eel 1 of Materials
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<br />DU NO PITE- 661,0 THIS LINE.
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