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AA Evergreen Err 'onmental Services N2 72995 <br /> Cont, .:rized Services <br /> dedicated to the protection of the environment <br /> To schedule a pickup,call Send payment to: <br /> Sales order# <br /> 800-596-9455 <br /> Evergreen Oil;Inc. <br /> 6880 Smith Ave.,Newark,CA EPA#CAD982413262 Dept.LA 23234 <br /> 16540 S.San Pedro St.,Carson,CA EPA#CAD982413262 Pasadena,CA 91185-3234Date: <br /> GENERATOR/JOB LOCATION BILLING INFORMATION <br /> NAME <br /> � ny/v NAME CASH CHECKOF <br /> (� <br /> ADDRESS ADDRESS <br /> # <br /> CITYSTAT ZEP - CO. i'ITY -- J <br /> y STATE ZIP CO. 0#PHONE NO._. PRONE NO. PROFILE NO. CUSTOMER EPA ID NO. <br /> �.�.., <br /> PRODUCT WASTE MANIFEST - <br /> CODE ht'^-,tDFR QUANTITY PRICE AMOUNT <br /> Waste Latex Paint "— <br /> Waste Latex Paint(Non-RCRA) <br /> Waste Paint Related(Flammables ait bttsetr. ---- <br /> Waste Paint Related(P7amrna'C1 s oiJ based <br /> Waste Aerosols Cans ! --- - <br /> Non-RCRA uardTouc Waste, lid(Soil, - - � - <br /> Ihbiis coataminamd wi t um h <br /> Nen-RC mirwtdous aae;Soh'(orf, <br /> Debris contaminated with <br /> Waste Corrosive Liquids,n.o.s. <br /> Waste Flammable Liquids,nn.s. <br /> Waste Flammable Liquids,n.o.s. <br /> Noa-RCRA Hazardous Waste,Liquid - - -- <br /> - ------------- <br /> Non-RCRA Hazardous Waste,Liquid ----- <br /> ------ -..- -.. <br /> Waste Toxic Liquids Solids(Class 9) <br /> or I — -- <br /> Waste Oxidizing Liquids or Solids <br /> Drained Used Oil Fi ters — <br /> Non Hazardous Water J -- <br /> - - <br /> Non Hazardous Water - c _ <br /> Nan Hazardous Solids <br /> Non Hazardous SolidsGlycol Bulk 50/50 -- -`T- -- --- <br /> (glycol Bulk Conc. -.__ —,_- -- -- - —.-- <br /> r AM <br /> T4 F TOTAL CH <br /> ARGES <br /> Evergreen Oil,Inc. SA Recycling <br /> 6880 Smith Ave. ❑ 332101/esteni ?, <br /> Newark,CA 94560 Union City CA 9458 <br /> CAD980887418 CAL000344510 - <br /> ----- _ ' <br /> Source: D Collection Station i (�rt7dCTl'ia l.. t Generator certifies that it has established a program to reduce the volume of <br /> Marine L) Agrieultl 1' quantity d toxicity of the hazardous waste to the degree determined by <br /> f I I1 i�!iatrial generator to be economically practicable. <br /> I hereby certify that I have rea and have the authority to <br /> Retain sample#_—_ bind the above listed generator to the terms on the reverse <br /> side of this form. <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. <br /> Per California Health and Safety Code Section 25250.9,Evergreen hereby advises customer that customer's shipment of used oil may be <br /> transporte a aci11 that is required to comply with federal regulations applicable to management of used oil,but that is not required to <br /> C ith the more tringent requirements applicable to hazardous waste management facilities.California facilities that handle or process used <br /> oil required to mee those more stringent requirements,and some out facilities that also meet those requirements. <br /> process used oil <br /> se include more s ngent leak detection and prevention requirements,engineering certifications of tank integrity,and financial assurances for <br /> osure and accident S.It is to send used oil to out facilities that comply only with federal used oil management standards <br /> d not these mor i utrements.This notification is for information purposes only. <br />