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FROM : L.F.W. MFG. INC. FAX NO. : 209 465 6521 Feb. 16 2007 11:54AM P8
<br />.24 WORK kDRD 41.11ERVICE,AC ; ,WNT
<br />Evergreen Environmental Servlcl%",�Is NO 3 8 5 2 8
<br />dedicaled to lire prudrrlinfr rij Thr, environment
<br />To ` QU )edUle I PiCX11P, Call Serad paayincrat to. Sales Order
<br />$i�,,��pp��qq ��±+ [['�� /g y
<br />'x,60-596- 455 PvcrL>rl'cn Oil, InC.
<br />8880 SrtritYi Ave„ Newark, OA EPA4f CAD982413262 Y.(). BOX 30-517
<br />18540 5, San Pedro St., Carson, CA EPA# CAD982413?82 Los Angeles, CA 94030-0517 Date: a`7
<br />GEN7E]R.A,'i[ORIJOS LOCATION BILLING INlFORMATIION
<br />IVAAJ
<br />WASTE NIANIFEST QUANTITY
<br />CODE NUMBER
<br />UNITS
<br />NAA�IF
<br />.. _
<br />❑ CHECKr
<br />Em C
<br />(ial.
<br />Waste, Liquid Indusr4a1
<br />#CASH
<br />AD 15U, S
<br />n9<. S
<br />ADDRESS
<br />C',;A134
<br />CUSTOMER CODE NO.
<br />I 2�w a Q
<br />CI STATE
<br />dllP
<br />CO.
<br />CITY
<br />S't'AT : ZIP Co.
<br />PO #
<br />PI-IONE N.9.
<br />Oil & Water, Nun-RCRA Hazardous Waste I,.iquidJ
<br />CA221
<br />_--
<br />PRONE NO.
<br />—
<br />PROr, ILE NO.
<br />CUSTOMER EPA; ID NO,
<br />(' 5-0(jq
<br />-
<br />( )
<br />__.�.._
<br />G16fiO3
<br />PRODUCT
<br />WASTE NIANIFEST QUANTITY
<br />CODE NUMBER
<br />UNITS
<br />PRICE
<br />AMOUNT
<br />Used oil, Non-RCRA Hazardous Lobric: iting
<br />CA221
<br />(ial.
<br />Waste, Liquid Indusr4a1
<br />CA221
<br />A
<br />Gal.
<br />ince 11=7ive Antif tvm Nw-RCRA Ha&1rc1) x
<br />C',;A134
<br />Ural.
<br />Ro WA*1c CiuiaU-liblc Liquid. N.U.S. NA
<br />mn n1 Oil coorur,iru�n,d wish ludo u,,v
<br />�A221
<br />r (ro,02
<br />Gal,
<br />Oil & Water, Nun-RCRA Hazardous Waste I,.iquidJ
<br />CA221
<br />_--
<br />GaI.
<br />—
<br />Waste Solids and Sludges
<br />^
<br />Gal.
<br />Wash Out
<br />Tach
<br />Urdir e(l Used Oil Filters
<br />Drum
<br />Non-RCRA flazaudoas Waste Snlids (oily debris)
<br />CA223
<br />Drum
<br />Empty Drurnti
<br />Drum
<br />Transportation
<br />HYS.
<br />Non Hazardous Water
<br />Gal.
<br />Glycol (Bulk 50/50
<br />Gal, _
<br />®–
<br />Glycol 'Bulk
<br />Gal.
<br />".,,r�� ``��
<br />TEST. Clot D Tech 400dZA9; ppm Ll Clor 0 'Tech 100 Pass ❑ Fail ( J llalogen Dciectof/Flame Test ❑ Pass ❑ Fail
<br />. �)
<br />Picld Service Work Description!
<br />Total Clliirgcs
<br />Other:
<br />Vacuum Services 'Time _
<br />Outof Yard On Site Off Sitc ._. Off Load Surf Off Load End _ ReturnJto Yard
<br />TSDF WConsolidated Manifest
<br />Evergreen Oil, enc, Evergreen Env. Svc. Evergreen Env. Svc. ❑ AJS filter i-1
<br />6880 Saaidl Ave. Road 30B L 14139 N. Valentine 15I l Ctark Ave, i. _i
<br />Newark, CA 94560 Davis, CA 95616 Fresno, CA 93722 lndtlstry�; �C•A 91745
<br />CAD980887418 CAD982446874 C'.AD9R2446892 CAD000097432
<br />Evcrgrren Env. Svc. l__j Evergreeil Env, Svc. E CFR CFR Greenleaf Env. Svc.
<br />10604 S. San Pedro 1 745 A West Betteravla 944 E. Slauson Ave. 33210 Weite n 1474 Toyon Circle
<br />Carson, CA 90746 Santa Maria, CAL )3454 Los Angeles, CA 90011 Union City, CA 94587 Valley Sprin,s, CA 95352
<br />CAD981696420 CAD98244685R CAL000110021 CAL(X)(N))1507 CAL000214411
<br />Generator certifies that it has established a program to seduce the volume or
<br />Source -'No Collection Station :1 Government quantity & tuxicity ul' the hazardous waste to rhe degree determined by
<br />® Marine 0 AQrJcultural ® Industrial generator to be economically practicable.
<br />I hereby eertil'y that I have read and have the authority tit
<br />bind the above listed 2eneratnr a the terms on the reverse
<br />Retain Saalapp� �„ ... _ side of this forth.
<br />IMPORTANT NOTICE RrtGAR DING THE DISlPOSITION 01, YOUR OM.
<br />Per California Health and Safety Code Section 25250.9, Evergreen hereby advises customer that customcr's shipment at' used oil may be
<br />trtansportcd to a facility that is required to comply with federal regulations applicable to rganagemcnl. of used nil, 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
<br />oil are required to meet those more stringent requircrruents, and some out -o£ -state facilities i.hal. process used oil also meet those requirements.
<br />These include more stringent leak detection and prevention requirerncntc, engineering certifications of tank integrity, and fiminciai ascurancer, Ior
<br />closure and accidental releases, it tS linvl'ial to r:end used oil to oat -of -state racililir:a ural comply only with federal used oil rnanalgement swnd:rrd.s
<br />and not these rnonr st ' t requirements. This notification is for infi>rcnatiun purposes only.
<br />
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