COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

WORK ORDEIZ/SERVICE AGREEMENT Evergreen Enviimental Services � 0� ; �� ;YyS Z 0 11c(licalco'to thr prntec run a/ ih�� cnrirunnnut To Schedule a pickup, call Send payment to: Sales Order # _ 800-596-9455 Evergreen Oil. Inc. 6880 Smith Ave, Newark. CA EPA# CAD982413262 P.O. BOX 30517 16540 S. San Pedro St.. Carson, CA EPA# CAD982413262 Los Angeles. CA 90030-0517 Rite: _ ENERATOR/.IOB LOCATION BIi,I.ING INFORMATION NA1IE WAS -1 E COUE NAME CASH ❑ CHECK ❑ ADDRESS - ADDRESS CUSTO)1ER CODE NO. i CITY STATE ZIP CO. CITY STATE ZIP CO. i 1'O # PHONE NO. C, PHONE NO. Oil & \1ater- Non-RCRA Hazarnlous waste Liquid Mill"R 1 M ID NO. PRODGCT WAS -1 E COUE MANIFEST NLt\I13ER QUANTITY UNITS PRICK: ANIOt'NT l' -ed ,if. No• RCRA 11az;ndou� Lubricating i CA=''i Gal. I i i %V,mc. Liquio Indusuitd (A„1 Gal. I ('-J. -- .n��. �. \,.nrc ea n.,,.��a��,� t � C A l 34 Gal. C, Oil & \1ater- Non-RCRA Hazarnlous waste Liquid CA -1 Gal. \:paste Sulid. ;01.11 Sludges Gal. \Nash Out Each Drained Used ()it Filters ' Drunt i \.m -RC RA H:;zanirnt, AVaste Soiids roily dehri,) CA 223 Dt'um Emptc Urunt> Drum Transportation Hrs. Non Kizaidous Water I G'd vcol Bulk 50,150 Cal. ,;Iycol Bulk Cone. ( Gal. TEST:❑ Cloi D Tech 4000__ppnt ❑ Clor D Tech Iui)0❑Puss ❑ Fail ❑ Halogen Dctecio /Flame Test ❑ Pass ❑ Fail I Field Service AVoik Description' I Tom] ChLir,-'cs Other: Other: Vacuum Serticcs Time Out of Yard On Site 011' Site —011'Load Start Oft Load End Return Io Yard TSDF ❑ Consolidated Manifest ❑ Eergreen Oil. In El E\cr;reen Enc. Sce. ❑ E\cn-reen Em. Sce. 1:1AJS Filter El Smith ,arc. LJ Road 30B 4139 N'. Valentine 15131 Ckuk :etc. Nettark. CA 94160 Dacis. CA 95616 Fresno. CA 9372_' Indusuw. CA 91743 C:1D980Sa741S CAD9S'_446874 CAD9S'_44685'_ CAD060097432 F -1i2 Enc. Src. ❑ Ercr_reen E;1\, Sec ❑ CFR El 3' ❑ Greenleaf Em. Sic, 16601 S. San Pedro 743 A Nest Betleracia 944 E. Shwsrnl Ace. 33710 Wester it 3474 Toton Circle Carson. CA 90746 Santa Maria. CA 93454 Los Anecles. CA 90011 Union Citv. CA 94587 Valley Sprim!�, CA 95352 CAD981696420 C.AD982446858 Cal 000110021 CAI -000091507 CAI -0002144 I I Generator certifies drat it Jim estahlishcd a pro Arun to reduce the rolunte or Source: ❑ CollectlOL) Station ❑ Government quantity & toxicity of the hazardous wrote to the degiec determined ht ❑ Marliie ❑ AUICLIItLlral ❑ hidustL-1.11 tenerator to be economically practicable. I hereby certif>, that I have read and have the authority to bind the above listed generator to the teens on the reycrse Retain sample # side of this form. IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. Per California Health and Safety Code Section 25250.9, Eter«recn hereby LRIN s customer that customer'S Shipment of used oil may be transported to a facility that is required to comply Mth federal regulations applicable to man'gentent of used oil. but that is not required to ty with the more Ml-ingent requirenlentS applicable to hazardous waste management facilities. California facilities that handle or process used required to meet those more stringent requirements. and some out-of-state facilities that process used oil also meet those requirements. - include more StrinEent leak detection and prevention requirements, engineering certifications of tank inte_rity. and financial tissurancc for closure and accidental releases. It is lata-ful to send used oil to out-of-state facilities that comply only with federal used oil mana,-�ement standards and not these more strineent requirements. This notification is for information purposes only.