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<br /> Evergreen Envlronmenkal SeI vI �l° I Evergreen Enviironmental Services
<br /> ddrmedr 1,<p , o3M Redknaed en rnainer ized Sen•Icee
<br /> �y To schedule e pickup,call Send pa}runt to:
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<br /> r"z t t`860 972 284 e<rg oa,mf6„ i 800-972-5284 Evergr«n Oil,me.
<br /> �pggtta hA Npgmy i'Lt ngAA 3 2 1JepL 3r\7323�� 5 68e0SniNn9a.NewvR ew ePnA CAo Dept LA 23234
<br /> 4asgdd9y,Pddzd&`�Cdgba.eA Fn}eCAD98ada63 isa¢ariepa•CA 911E53x34 Dayb _..�... r6s49s sv,Pwvv<aova.cw npna wD9ex4i3z6z Pamdcna,CA 91165-3234 Date: >d4�
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<br /> GI I GENERATOR/JOB LOCATION< BILLING INTORMAT'ION
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<br /> PHONE NQ PRO{nLRNO r Coil EP IJ}NO Y N 'O. PHONE NO. PROFILE NO. SIEZ AID NO.
<br /> BOO/ $
<br /> PHODDC7 •n 3VASTE n_ T pUANTrIz( ONltd, >!R7G6 tAMi1UNT`, �c PRODUCP —_ WASTE MANIFEST QUANTITY UNIIS PRICE AMOUNT
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<br /> CODE NUER
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<br /> TOO _ r.tk•.`' �..1,H� waaM Toxx LrcrywswS°nds(Class 9)
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<br /> } 6@Ev WA✓; 30H AHs 4®N.Yakn .- •&Y "f TOTAL CHARGES
<br /> ,Newak.cAsasla TMvrKc'4956[63.P° y 1 ix { l
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<br /> ❑11gaB=a.+ne,©Aga iat Olndughlal kkkr4tf i sr `+ p Marine Q Agricultural ❑Indusldal n`alb r°man nit=i�nwa"=,.I w d n m mora.m
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<br /> Ra1PORt.,,,N C1 RE$ARDWG THE F
<br /> p7,'I QI 4$n7pN pF,ypUR OT J IMPORTANT NOTICE REGARDINGTHE DISPOSITION OFYOUR OIL.
<br /> PgrCgliN ry}Teall�s nd$af tYlCpPI.SectWn 252509 Ev`pfpr4en Ee by ad is`gt£ysmhttr% ryalPlpgfg§q ppwn(,et'.10 ay”, ',pf Per Colirorvis Health m,d Safety Code Section 252509,Evergreen hereby advices.lanorootbat customers shtpmm�[of used oil may he
<br /> imnsporl vfhci{fly thea N totgamp/Y A'1 G@I':S Iep4 ppl,cabkl ma b{tif9a�;ydb1 lKcq l{¢¢,Ivoy` wssported too f°nirtylhm,srequired so comply"imfedeml mgMatrons applicable to no-'ementofused oil but that is not q nklto
<br /> "coasnPly.,W;m rico rRP�e SlrivgerdSU an<nH:e(,pi,b /o Ira n I mmw a tTaCd nk`9,Lde{,CP+ri�L f3EEiQ Q{,t pndle 1;t8Fe;;s Cd' —Ply wnh me mom stnngent requirements applicable to hazardous waste managmrmt facil ties Cilifornia facihnes that handle or process used
<br /> 6 MI are rs r<a1 aPeeriipp.44.�mde<ani,aml aenmma aha` t f as rb u oa`dwtemixEa gso5C6,R elsd<mEelldl��pgke+2u. "q3 , o I are mrze to c<t Ilmre more ndngenl rega;remenn,aha some our or amt<feaiihea[nal Pn,ce hoed wl also moa moae regoiremenp.
<br /> Thg9g,uie�pdP, ag trlagrp)j.7q Qe1 'd prcvrnm ae?fu'vem t gtne'ringceniNdat{bilRgf[p,t�;in iM1pfi¢pR�il Ss ndafpr: licca' 'gent leakdaeaionatM prevention requovoico.s,,ogire<nng<ertifcauans of tank mtegrny and financial assurances for
<br /> tWo ggdye<deptal (ea?!,�I{f{g I Id'seM ttd?a,li l oi•1vl facial l �dlat cmgplY 2ynh f Vegd o}l in 6ge t fa?dmdt : rz d ecmdents ml s R'lawful ro send used ori to w of aceta fxalirea mm oomply only with fedorol used oil me nig,o—t standards
<br /> aol4�<u m geM i,mnents Thi,ImtEc fm f t purppse;gglyy 't 1 nd nut(hese m niremenm.This nonficnhon is for rnformalion purposes only
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<br /> >y nlggattg8 �'Pn INa e Route# Date a t ��Igtute IY4flti NeM$U Data ! Driver Signalure Print Name Route# Data Cenem Dr's Sianamre Print Name to
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<br /> WORK ORDER/SERVICE AGREEMENT I p
<br /> Evergreen Environmental Services N° 693259 , Evergreen Environmental Services
<br /> N_ 95349
<br /> / schedule
<br /> d e a pickup,c opn<ema w„nem JJ col mmedmd sm"rloea
<br /> To schedule a pickup, Send payment In: ( 75; % 7o schedule e p ckup,celif 1Ae e ,v Send pa t to: 3
<br /> Pi P Sales Order# }'n1P° Sales Order#/l�PP/6'•SL7
<br /> 800-972-5284 Evemre<a Oil,ma. 800-972.5284 Exerg—OB,1—
<br /> 6880 snuu n.<.Newuk,cid FP Dept.LA 23234 Dep.LA 23234
<br /> D9s2a13�6z P—di,-CA91185-3234 Date: /Z'f� M121— Pasadena,CA91195-3234 Date:
<br /> GENEftATOR/JOB LOCATION<w BILLING INFORMATION GENERATORIJOB LOCATION gc BILLING INFORM TON _
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<br /> NA— CASH❑CNECK NAME NAME CASH Q CHECK
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<br /> ADDRESS ADDRESS CUSTOMER CODE NO. ADDRFSg pDDHE55 CUSTOMER CODE NO.
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<br /> CITY STATE ZW CO., STATE up CO. POA CITY SCA CO.CITY STATE ZIP CO. POA
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<br /> PHONENO. PHONE NO. PROFILBNO. CUSTOMER EPA ID NO. PHONE NO. PHONENO. PROFSLE NO. CVSTOMER EPAm NO.
<br /> 99 ( } o ll 38 t )
<br /> WASTE MANIFESr WASTE MANIFEST
<br /> PRODUCT CODE NUMBER QUANTITY tll\TTg PRICK AMOUNT PRODUCT CODE NUMEER QUANTITY UNITS PRICE AMOUNT
<br /> USM OJ,Nan-RCRA Hermd°ua Lubricet nig CA22 Gel. N Lorex Poinl(non-RCRA)
<br /> Wazte,LiquW Iduslriai CA221 Gal. \Valle telex Pool(Non-RCRA)
<br /> GA221 Gal. Waste wRward(Flamm,blesoilbo,0 _-.--
<br /> i°a�awrcrmm.uur+z+a.nna�awrm.< � GAL Wazm Paim RelarM(Flemmabla wl basM)
<br /> Wave Aaasols Cnns
<br /> Oa&Wamr,NamRCRA Elazmdov Wave Lquw CA223 Gei.
<br /> Nan Hemztlma\Yemr Gal. - --
<br /> wasmSolMsaMsuk.. Get.
<br /> VaM1 Wt _ Evch Ste Flammable Liquitls.ns�s.
<br /> Presnue wasberlSrean Cleercr Day urs Flammable L'rquiee,a.o.s.
<br /> Non-RCRA Hazawoas Wave,L'quia
<br /> Trans lin. j Nan-RCRA HozoNous\Vent lJquM
<br /> pwimion _ _ _
<br /> \Valle Toxic Ligwds or Solids(Claw 9}
<br /> Fuel Surdraige 9 Wane Oxiaizin l: Qsm Borids
<br /> ( Glycol DWI, Sols'ay Pmamt Gal.
<br /> Gy�ml aul�owJSpedfY 1'matrct Gal.
<br /> Omind Used Oil Fillers - -_- -- _—
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<br /> TE4'n CIw D1kd,4aAaaZ&ksm �]CIw DImh1000 _Pvis ❑Fal Non llvzeMws ware
<br /> Retain sample#62 Total Charges j Nm a.—.awamr
<br /> ReUuired
<br /> G(,�`Z Non iiamrdaus Souris
<br /> FILM Service\Vwk OeudpO -'--�---- ''.. Non Harmaous Saida
<br /> ' —'-'- Glywl Hulk Sw50 '
<br /> Other: _._ .... .._.
<br /> Olhr. 'i Clycol Bak Cn,c ___
<br /> T5 Consolidated Manifest DRIVPR CHECKLIST
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<br /> 0=04”.-ISE❑ErcrgrunOil,kc.-Fresno onmelti—nma our _
<br /> fi880 SmiiM1 Ave. 1139 N.Mkmix plan— Ndyls W TOTAL CHARGES
<br /> Newmk,CA945(d D CA95616 Bush CA 93722 _
<br /> CAD98onolls CAniset446p4 CAD9824468g2 ❑Arcumuladon Stan Rite Mmkd TSDF yycc
<br /> ❑ Shen Perim..❑-17=044Aaure.'u❑... ...00NercSeme'es Cbecad:Orrr01(•O PdiemlOmmn Cl Aniiaeex _❑6880 SmMAverc.. ll210 k4smm ❑..... .......
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<br /> Carson,CA 9015 Sema Merm,CA 93154 G(y,lkd,n wMr mn,cea mNd Oil, Fille�Nmma. Am4rccze Newmt,CA 94560 ti—Ch,-111
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<br /> CAD9816964 CAD982446858 CAD9Wear418 CA-344530
<br /> Ge°emi ibaihm hlma aiabliaM1edepmgram lordutt the volumew Gmcemlwrmifics Thar it MseanbiishM apognmwreduce the volume or
<br /> $OUICe: GOIiCCI100 Station ❑Government quam'dvy&wiwryarace M1wvdamn t othedegrecdelermined by $OUrce:QCGReCtiGll$1wIDn ❑GDYemnlenl gvunmy&roxinry of the lmzadous wane is the degree determiwdby
<br /> ❑Marine gAgSieultural❑Lidusuial aeaa i m anwniwlr pm=dcmke DMazine ❑Agrieul[isal Uhidushia! g4nemvnobe er000mirally pmnkabk. ,i'
<br /> i n c=Dairy m l I h d d o 1 m of l I n b Inn I n a I ha.<we aaa,orily m
<br /> ni a 1 ha n lea t 1914.c ma o,me reveraa nma n o above lista 1 Renamo.,to me km to
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<br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL IMPORTANT NOTICE REGARDING THE
<br /> DISPOSIT DN OF YOUR OIG
<br /> Per C.Iff—ia Health and Sahly Code SP,,4—25250.9,Evergreen hereby advises cosioma that customer's shipment?f..d oil ,be Per California Health end Solety Code Section 25250.9,Evergreen hereby advises cuamrner that cus -sishipment of used oil rosy be
<br /> transported too fcility thati8 regoiceil wcomplywimfedemiregula(ions applicablemmanagement of used oil,but that is not requud to 'i, transposed ma(onility fa[a regvhedmcomply wi[h(edwei regulations epplicablelonanagemeiu of usedoil,but thatis trot required to
<br /> omply wish[he mom stringent requirements eIn,I k m hamda-waste management facilities.California facilities mat handle m pmcesa used ply with the more nringms requirements applicable m hazardous waste management facilities.California facilities that hurdle w process used
<br /> c'1 are required to met moae mare stringent mquiremcros,and some ou[-of-state f ilities Nal Praceas usrA oil also m hose sequireroenm 'I are ieq Q[o men those Anngent requirements,and some out-af-state facititiea that Pro used oil Mso then those requicmneurs.
<br /> TMs include more stringent leak dereca vw preveafien regairemmts,enginee,ing cenifieatiors of 'ty,nd ff.acid assurances for Theze indudJyore9a"gent leak detection and prcvaWon requirements,engineering zcni5canons of IaNc integeity,and fnancisi assuno—for
<br /> ci vid arxidentil release.It is lawful to ttnd aced oil m Duro[-state facilities that comply onI ua1 used oil management sMndards closure d' ideotal r leases.ft is lesvful[o seed used oil to outrof-srace facilities Nat comply only with Federal used oil management standaNs
<br /> these mare stringent requirements.This notification is[or iN'annetion purposes onl. and these enure ctrl gent requirements.This notification is for information purposes only.
<br /> over Signature 'Dt Name Route# Yate moue Print Name Date
<br /> while copy=caatamar copy-MNrgVellox cosy=rntire use-Gree copy=pnaa,to mamkar-Gowan copy-ornrer copy Driver Signature Print Route# Date Generator's Signa re Print Name Date
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