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jFREMOUW JEi71RONMENTAL SIWVICES9 INC. <br /> Send Payment to: Phone: 800- 59-3274 EPA ID#CAR000171017 <br /> Se y INVOICE # 19 715 <br /> P.O.Boa 2875 Phone: 707-448-3700 U,S.D.O.T.#1484667 <br /> Vacaville,CA 99696-2875 Fall: 707-448-3499 D.T.S.C.#3544 Date L 0'1 0 <br /> wrw�wr,�wwteremoval.COM CA#274461 <br /> BILLING/MAILING ADDRESS <br /> SITE ADDRESS C.O.D.O.D. <br /> Customer AJ F & Mart Customer_ <br /> 7906 N. El Dora -o Street 7906 N. E! Dorado Street <br /> Stockton, CA 95207 Stockton, CA 95207 <br /> E.P.A. GAL 0 0 <br /> n 491 Phone <br /> Additional Contacts: 209-957.2987 <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 . 14 • 21 - 30 • 4a • 60 - 90 � 180 • 365 W/C WASTE MANIFEST NUMIIER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> Drained Used Oil/Gasoline/Diesell Filters N/A <br /> txl RCRA Hazardous Waste Soli V A V 0(v Q q 107JXK D/Mdr CAN <br /> '1 <br /> Exduded R"dable Matenal (Late Paint) WA <br /> Waste Paint Related Materials, 3, U 1263, PGII 31/0001 <br /> Waste Aerosok,IFlelrimable,(Each not eceel 11-capocity),21,UN1950 3300011 <br /> Combustible Liquid, N,O.S., NA1993, F Glll(Helogenated 01) 41/F002 <br /> Non RCRA Hazardous Waste Liqui (Oily Sludge) f1CA 723 <br /> Empty Drums Provide [—] Remove D 1 A 1 1 A2 5g❑ 1 Og ❑ 15g❑ 30g❑ 559 P F <br /> Clor-D-Tett Q4000 Test)(it: Test❑ Pass D Fall ❑ Generator Knowledge ❑ PPM <br /> Transportation Charges/Additlo Truck Time/Additional Labor/LAB Packing/Site Cleaning <br /> Clean: Y N Labels Oil ti.,LA A/F N ¢ UOF N A Oily Debris of <br /> SERVICES REQUESTED BY TAX e 3 <br /> A ce t = P.O•# TOTAL CHARGES: 3 <br /> GENERATOR'S CERTINCATION: I hereby declare 10 The contents of this Consignment are fully and iccvrdtely oescrlbec above by proper 5hippng name and pre clasilred,packed.marked.and <br /> labeled,and ore in aR respects it)proper conattion or transport by nlgi according to appi;coble stare and notional government regulations. If I am o large quantity generator,I certify that I <br /> have a program In place To reduce The volume an toxicity of waste generated to the degree I have defer T>ott9 10 oes eCOnom.iy p,ociiCoble and that I have 9eieCted the praCtlCobl®mefhad <br /> of treatment,storage,or disposal rvrrenfly civoilabie to me which minimized the present and future threat to human health and the environment;OR.It I am a small quontity genarafar,I have made <br /> a 9gootl faith effort to minimize my waste generarla ono select the best waste management method that is available to me anti that I can afford, Allused Oil from the genefator fisted above <br /> wtA be Transported only to a facility permMed by fir 9 State Of Caltomla t0 pTOduCe used ail into recycled off OR a faClq y ThoT Is required to Comply with Federal reguMion9 applicable to Tile <br /> management of used oil. All relevant Information r garding known or 5uspected hazards associated with this woste has been disclosed. The customer agrees to pay reasonable costs and attorney <br /> tees Incurred In the coliectlon of this obi wlon. Ve us for u ose5 of fills obi abort shall be in SOlona CountI declare under enalf of e u that the forgoing is true and Conect. <br /> DISPOSAL/RECYCUi FACILITY: Council.,Station Indusitfal AOIC0tvre Gavemment Marine Othef a, Wit Oy"np <br /> l Yedla F.S TeeMicM 3•Iu6an,LLC Ile Frohction Sennas,tnc. l l Rirni ire_ [ I pis sle FAvo lr mt-I "I" "lly Enc <br /> TA 4Ye9t laaAW� 7D C Clllt f Sf..Unt 4 OiOQ Artnu6 101 W Charnel Road FIEv IN b Or,EaN <br /> 1 Phornet V 95M 2 CA"545 3 CR9251X7 1 Btsa-&CA U510 5 Fel Yep fN 8�91L16 <br /> BOR36& AZ000fX�47360 ''QE61B CRROm188f318 18111L000E CAR 77218 Sla-%ar-2r?E CALOi1070169f' r75,5��0 ,yypAlOROi'Cf8 <br /> O- L'4'T v� <br /> Pi me G neratces Signature *942 <br /> state Law Requires that you keep this ReCeipit/iii ading on nle no less tha <br /> To Re-a,CTlvate or to obtain an EPA q Customer may contact DTSC 19 1-800 <br />