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.4"V. 0 <br />l i89 VANDERBILT SI142 F"MOM ENVIRONMENTAL SERVICES, INC. SERVICE ORDER / INVOICE: <br />Manu, CA 95337 CALIP0111IA COOLANT SERTICE { ; <br />OFII(E: 209-239-5587 Tronsparler EPA# (AR000171017 <br />FAx: 209-239.6316 U.&D,O.T. #1484667 D.TS.c. #3944 CA# 274461 DATE:In - <br />Customer btet�1.13s wl pmpnr Co. SS CUSto erttf+GA tkertnr�tiorll�l P.1per co, <br />--1550 Ulywko RoudCt:ttUu➢ttt ili'A # <br />gitwktum CA 95215 11.0. Nix 7b8 <br />Milford, 014 45150 <br />E.P.A. # CAL 0010 204 756 <br />Addltlonal Contacts: Adam Meson <br />Phone <br />209 93137(* <br />20,91513 9005 <br />PAYMENT TERMS: NET IS <br />PRODUCT - SERVICE INFORMATION/ PROPER SHIPPING <br />DESCRIPTION <br />WASTE <br />7 • 14 a 21 • 30 • 48 • 60 • 90 • 180 a 368 W/C CODE <br />MANIFEST NUMBER <br />QUANTITY UNITS PRICE <br />AMOUNT <br />T.e01pa Non fx 1'I' Rgpd=4 Phwrtt wA= M.Wu 'fubos fl <br />Q(i(— <br />�U <br />^�- <br />L11mpA Nm1 lX-rl' Rgpihled. Fluweaud Iion 'i'utme 11 <br />11,64M RIM Our R;P—vm Hui Mw kawMIRME. RMI RMIN. <br />gy Vim) <br />-- -- <br />IM <br />8110 #133 <br />AwlWvyalref)K20,0154NS <br />J 2 <br />ltcryelNty.) <br />"GUMer, tAp, Ivan Us 1301 Rntulakd (Uaad All oilne "ento for Rcdit j <br />- - <br />Nun-l)OT ftuluted Halo Fu Reuyehng (Nml-PCH liulllf Aa) <br />Non-Wrl RmWwod VWudlaw far tw W11htg (Nos--Kls Cquttgwe) <br />ion-1XUT Repdded l4ecUtuiK SqulgnuM Ix lUcyrlfnp, <br />,., , 10(ulun OWS 2. J.PIJUI— <br />t!x <br />Om <br />Vt ov c'- C F+L Sia G. ' <br />►, ,, <br />., l•95 <br />1 1`S e, )stn A(V >* S <br />F <br />Empty Drums Provkte O Remove)t Al AZ 59 O 109 ❑ 159 O 309 ❑ U19A W P F <br />I QM (� <br />Cior-D-Tett Q4000 Test Kit: Test ❑ Pass D Fall O Generator Knowledge O PPM <br />Transportation Chargee/Additional Truck time/Additional labor/ LAB Packing/Site Cleaning <br />clean: Y N I LaDw foil A/F UOF sly Debris <br />SERVICES REQUESTED BY I TAX 7.375 <br />WZ <br />P. O. // TOTAL CHARGES: <br />yNor wo conwrin or INS axwwrUntan. a prepet name are Ono <br />lasted and as h Rtl rAlpsoK M oane511on for Irarupeel bV highway aecoreSrlo,lo appYeeble pate and natbnd government I ;:* om. f 1 am o terga quanthy genwotat, I eeAlly that 1 trove <br />a program In pbce to reduce the ktme and Ioxkw*v of waste peneroted to the d�eecprreeee 1 have determYjad lobe economicaly practicobW and Phot l hove aMcfed the mettwd of <br />heatmenl, gotope, at dbposd curtently avollabb to me which mNmlzed the prase wW future threat to human heollh and the anvtonment: OR, h I am a trrol quantitygenerator, l rove mode o <br />foBh etlart to mtrWrate my waste and select the beq watts monegemenl metho that Is ovaDoble to me and that 1 can afford. AD used W from the generator listed above will be <br />rletl oNy to o facmty permatxJ the State of Coliforrvo f o produce used o1 Into recycled dl OR o facility that b requged fo comply wah Federal regulations appgcable to the management of <br />used ou, All relevant fntoemodon reportting known or pgpeoted htunrds tusoclottxi wflh Ihb worts hiss been tihcbsed, the customer agrees to pay reasotable costs and aHorney fees h wffed in the <br />oolectton o} thio .Venue rot purpaes o} Ihb obDgailon poll be M Solaro County. I decJ�e under PelotlY of penury that the forgoing is true and cortecf <br />DISPOSAL/RECYCLING FACILTY: CollscMon Station IndUlMW Agriculture Government Marine Other induoftlo , ng <br />8#"aak*=, ac GpWMematantd a pJaacaatywc <br />3900 BadRnplur SS. 0 MMIAve lWa AJ;P tr4r.dhtdd 1hry91 Mutt afey to lJWwwAmtwm FWl <br />Glut poedr,l,%YtM7 WAt+rrnae rem ILIA faun Ib Ml <br />Ql MI 1p7tr SRL:G)-loiK+071��n6A [4N ri yam, GA INS97 pamr. Int 09071 VdeaWK(.'A95110 <br />C3a1.7 +rJI•il•1 ro! (77✓) `31 X7Dl 707.071 )z <br />,u' ��'%� �� l� tU �j of . ' ,,, ' ,,...--•-- y ,1 � - '�)Z. <br />Prktt Name a 8tgnaAue DrIveel Slonch re <br />I h*Mbg aft Ihel I hrnre Need end hmre fln nUftft_I bind the afire listed y7eneratar fo fit ms,.an the rweree We of this_forlm, <br />