Laserfiche WebLink
1 <br /> 4 Evergreen Em ' mmentai Services N® 72969 <br /> Contax sized Services <br /> dedicated to the protection of the environment <br /> To schedule a pickup, call Send payment to: Sales Order# <br /> 800-596-9455 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 91185-3234 Date���+ 4 <br /> GENE ATOR/J B LOCATION BILLING INFORMA'T'ION <br /> NA ,. <br /> AR <br /> mr <br /> v NAME CASH Q CHECK El <br /> -- # <br /> SS, - _ ADDRESS CUSTODE NO. <br /> CI STATE ZIP CO. CITY STATE ZIP CO. PO# <br /> PHONENO' � 4 PHONE NO. PROFILE NO. I C STOMER EPA ID NO. <br /> PRODUCT WASTE MANIFEST QUANTITY UNITS PRICE AMOUNT <br /> CODE NUMBER <br /> Waste Latex Paint(Non-RCRA) — <br /> Waste Latex Paint(Non-RCRA) -V <br /> Waste Paint Related_(Flammables oil baser]I <br /> Waste Paint Related(Flammables oil based) <br /> Waste Aerosols Cans <br /> Non-RCRA Hoiacdous Waste.Solid(Sail, <br /> nebris contaminated with troleum h drocarbons) - <br /> .Nw RCRA Huurdous waste,Solid(Soil,1 "—'— --_ __.-___ _._._._ -. •. <br /> Debris contaminnied with Petroleum hvdmcarbons) <br /> Waste Corrosive Liquids,n.o.s. - <br /> Waste Flammable Liquids,n.o.s. <br /> Waste Flammable Liquids,n.o.s. <br /> Non-RCRA Hazardous Waste,Liquid - —` <br /> Non-RCRA Hazardous Waste,Liquid <br /> l <br /> Oxidizing Liquids or Solids <br /> Drums <br /> azardous Water <br /> Non Hazardous Water - -- —— <br /> Non Hazardous Solids —_— <br /> Non Hazardous Solids <br /> Glycol Bulk 50150 -- -- — <br /> Glycol Bulk Conc. <br /> ---- _. ____ cam• � - <br /> _ — _ <br /> TSllF <br /> TOTAL CHARGES <br /> ,_,,��, <br /> Evergreen Oil,Inc. I-1 SA Recycling t �" R���1� ��`'l�J , L� <br /> 6880 Smith Ave. L—J 33210 Western <br /> Newark,CA 94560 Union City,KA 94.587 ' <br /> CAD980887418 CAL000344530_ _ <br /> Source: Collection Station Generator certifies that it has established a program to reduce the volume or <br /> ❑ ❑GnvClrlmCnt quantity i4 toxicity of the hazardous waste to the degree determined by <br /> ❑ Marine ❑ Agricultural ❑ Industrial generator to be economically practicable. <br /> I <br /> hereby certify that I have read and have the authority to <br /> bind the above listed generator to the terms on the reverse <br /> �e1t.�Il)rfl sample # —. 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 /> transported to a facility that is required to comply with federal regulations applicable to management of used oil,but that is not required to <br /> comply with the more stringent requirements applicable to hazardous waste management facilities.California facilities that handle or process used j <br /> oil are required to meet those more stringent requirements,and some out-of-state facilities that process used oil also meet those requirements. <br /> Th ore stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial assurances for <br /> osure and acci ntal releases.It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards <br /> and not these mor stringent requirements.This notification is for information purposes only. <br />