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Send Payment To: <br /> .Independence Independence Environmental Services, LLC ''' <br /> r P.O. Box 12623 0 .0 <br /> 769 <br /> Environmental Fresno, CA 93778 <br /> CAD983589631 <br /> Services 800-971-8010 I <br /> DATE ' 2 f <br /> GENERATOR/JOB LOCATION BILL TO <br /> NAME PO# <br /> _ <br /> ADDRESS U /1 PHONE NO. <br /> 2 r( 7 "tl s <br /> CITY STATE ZIP GENERATOR EPA ID NO. <br /> PRODUCT CODE MANIFEST NUMBER QTY UNITS PRICE TOTAL <br /> Non-RCRA Hazardous Waste, Liquid 221 GALLONS <br /> (Used oil) <br /> Non-RCRA Hazardous Waste,Liquid 133 GALLONS <br /> (Used Automotive Antifreeze) <br /> Non-RCRA Hazardous Waste,Liquid 223 GALLONS <br /> (Oily Water) <br /> Drained Used Oil Filters DM/55 <br /> Non-RCRA Hazardous'Waste,Solids 2 _. e;'i. ate•i C.. �. a <br /> Non-RCRA Hazardous Waste,Solids <br /> Non-RCRA Hazardous Waste,Liquid <br /> Waste Paint Related Material 214 <br /> Waste Flammable Liquids 213 <br /> Waste Aerosol Cans 331 <br /> Universal Waste,Lamps <br /> Universal Waste,Batteries <br /> Empty Drums,New <br /> Empty Drums, Disposal <br /> r <br /> TSDF-OILICOOLANT TSDF-OIL FILTERS TSDF-OIL/OILY WATER TOTAL CHARGES <br /> World Oil-San Joaquin,LLC Commercial Filter Recycling Riverbank Oil Transfer <br /> 14287 E.Manning Ave 33210 Western Ave 5300 Claus Rd <br /> Parker, Ca,93648 Union City,Ca,94587 Riverbank,Ca,95357jb <br /> F_ <br /> 559-498-0240 510-487-9277 209-863-8181 � <br /> CAL000102751 CAL000491547 CAt000190896 <br /> Generator certifies that it has established a program to reduce the TRANSPORTER 51GNATLJRE DATE <br /> volume or toxicity of the hazardous waste to the degree determined (y ''� f`.— � . <br /> by generator to be economically practicable. <br /> GENERATOR SIGNATURE. / DATE <br /> I hereby certify that I have read and have the authority to bind the ` '^ •'' ,-�r <br /> above listed generator to the terms on the front and back of this form, <br /> l" <br /> Independence Environmental Services hereby advises used oil generator that generator's shipment of used oil maybe transported to a facility that is required <br /> to comply with federal regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable <br /> to hazardous waste management facilities.California facilities that handle or process used oil are required to meet those more stringent requirements,and <br /> some out-of--state facilities that process used oil also meet those requirements.These include more stringent leak detection and prevention requirements, <br /> engineering certifications of tank integrity,and financial assurances for closure and accidental releases. It is lawful to send used oil to out-of-state facilities <br /> that compfy only with federal used oil management standards and not these more stringent requirements.This notification is for information purposes only. <br />