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<br />Ct STONIER I:P3 11)\0,
<br />WASTE
<br />N1kNIFEST �
<br />WORK ORDEARN'ICE
<br />AGREEMENT
<br />Evergreen Environmental
<br />Services
<br />NO- 446774
<br />d<rlicerlt'cl trr the rareterriun ;,/ rhr
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<br />CODE,
<br />To schedule a pickup. call
<br />Send payment to:
<br />Sales Order C
<br />800-596-9455
<br />Oil. I„C.
<br />6880 Smith Ave. Newark. CA EPAn CAD982413262
<br />P.OBOX 30517
<br />2--7_� `� V�
<br />16540 S. San Pedro St., Carson, GA SPAN CAD982413262
<br />Los Angeles, CA 90010-0S 17
<br />Date: V
<br />GENERATOROOB LOCATION
<br />BILLING INFORMATION
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<br />PHONE. NO.
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<br />ST:%TE --IIP CO• I Crri STATE ZIP CO. = PO
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<br />PHONE NO.
<br />Ct STONIER I:P3 11)\0,
<br />I ield .Sen tec \tor} I>e,crs�tion:
<br />Othrc
<br />C)Ihrr --- �—
<br />b
<br />'I otal Charges
<br />P96 Consolidated Manifest
<br />�; . �,�. I ;-,�;� Int •,. i ;l — ___ _.
<br />a_ Cit a'• 1=1, CA
<br />Sot,tCC, J COilection Station r11111cllt
<br />_I Maritte �] Agrieultural ] Industrial s
<br />-- — — -- t hereh� certitl, that i have read and hase the authorit% to
<br />t hind the abovefisted generator to the terms on theever# i _ C�>!_��'�''-' _._form.- rse
<br />Retain sample- -
<br />side rrt this
<br />IMPORTANT NOTICE REG MUNI.; THE DISPOSITION OF' 5 Ot R OIL.
<br />Per California Health and Safet% Code Section 21250.9, [ iacrchv advise. -_�.,(rff,.. th Ll n
<br />u'ansportcd to a I" cilityHaat i, recxcreu l;, _'ramhly vcitlt ICL;:;l,riwm applicable
<br />cofitpll with the
<br />Oil are ;CyirirCtl tO r c4lui0 . .,.
<br />Thee inclu.lC [Mire r..t _ ��rn t ::'I. �. .rs� ._
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<br />an . of thc,e mire ,ving:nt rCquircn 1;1 :,,r t0l rn1,n purpo"cOmh.
<br />A�,de
<br />D cr Stt2nature rite \lime Route = Date -jencrator', Si<unature Print Nanie :-/
<br />WASTE
<br />N1kNIFEST �
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<br />PRODUCT
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<br />UNITS
<br />PRICE A1iOUN"h
<br />CODE,
<br />NUMBER
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<br />t P ...ii
<br />I ield .Sen tec \tor} I>e,crs�tion:
<br />Othrc
<br />C)Ihrr --- �—
<br />b
<br />'I otal Charges
<br />P96 Consolidated Manifest
<br />�; . �,�. I ;-,�;� Int •,. i ;l — ___ _.
<br />a_ Cit a'• 1=1, CA
<br />Sot,tCC, J COilection Station r11111cllt
<br />_I Maritte �] Agrieultural ] Industrial s
<br />-- — — -- t hereh� certitl, that i have read and hase the authorit% to
<br />t hind the abovefisted generator to the terms on theever# i _ C�>!_��'�''-' _._form.- rse
<br />Retain sample- -
<br />side rrt this
<br />IMPORTANT NOTICE REG MUNI.; THE DISPOSITION OF' 5 Ot R OIL.
<br />Per California Health and Safet% Code Section 21250.9, [ iacrchv advise. -_�.,(rff,.. th Ll n
<br />u'ansportcd to a I" cilityHaat i, recxcreu l;, _'ramhly vcitlt ICL;:;l,riwm applicable
<br />cofitpll with the
<br />Oil are ;CyirirCtl tO r c4lui0 . .,.
<br />Thee inclu.lC [Mire r..t _ ��rn t ::'I. �. .rs� ._
<br />t: [r 5 re andLkl'L'3ttCn;..i �.,,. . . i.. ..� ,l::il ... ..teti lh5t 'j' - .. .,. .7: [,7..,;,.,_ 1 ..il .i ..J
<br />an . of thc,e mire ,ving:nt rCquircn 1;1 :,,r t0l rn1,n purpo"cOmh.
<br />A�,de
<br />D cr Stt2nature rite \lime Route = Date -jencrator', Si<unature Print Nanie :-/
<br />
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