Laserfiche WebLink
A&S Environmental Servi s <br />P.O. Box 186 <br />LaGrange, CA 95329 <br />(209) 538-0886 / Fax (209 538-2498 <br />EPA# CAR000176537 <br />JOB LOCATION <br />For Service <br />800-760-0019 <br />My I IN!`_ TWIMDM ATrnAi <br />Bill of Lading/Invoice <br />Date <br />NAME <br />NVIRONMENTAL • 80 Smith Avenue • Newmark, CA • CAD982413262 - (800) 972-5284 <br />%/ . <br />NAME <br />CASH U CHECK U <br />CA 221 <br />, <br />/-7 <br />Gal <br /># <br />ADDRESS,, / <br />izardous <br />CA 134 <br />ADDRESS <br />CONTACT NAME <br />CITY <br />STATE <br />ZIP CO <br />CITY STATE ZIP CO <br />PO# <br />PHONE NO. <br />r, r <br />Gal <br />PHONE NO. <br />PROFILE NO. <br />CUSTOMER EPA ID NO. <br />PRODUCT <br />NVIRONMENTAL • 80 Smith Avenue • Newmark, CA • CAD982413262 - (800) 972-5284 <br />WASTE MANIFEST QUANTITY UNITS PRICE AMOUNT <br />CODE NUMBER (For Time Of Service Only) <br />Used oil, Non-RCRA Hazardous Waste, Li <br />uid <br />CA 221 <br />, <br />/-7 <br />Gal <br />U ALTERNATE ACILITY <br />Used Automotive Antifreeze, Non-RCRA H <br />Waste, Liquid <br />izardous <br />CA 134 <br />Gal <br />Non-RCRA Hazardous Waste Liquid <br />Used Oil & Water <br />CA 221 <br />Gal <br />Oil & Water, Non-RCRA Hazardous Waste <br />iquid <br />CA 223 <br />Gal <br />Empty Drum Delivery <br />Drum <br />Empty Drum Pick Up <br />Drum <br />Drained Used Oil Filters <br />Drum <br />Labor <br />Hours <br />Waste Flammable Liquid Gas <br />CA 133 <br />Gal <br />Non-RCRA Hazardous Waste Solid <br />CA 352 <br />Waste Tires <br />Each <br />Waste Flammable Liquid Paint <br />CA 331 <br />Gao <br />M7 111:11 <br />Other: <br />- - 19 lkw <br />Other: <br />T t: 2017 <br />Other: <br />Other: <br />t ; , L <br />i <br />Other: <br />Tax <br />TEST <br />PASSC] FAIL U PPM Test <br />U Collection Station U Agriculture Soce <br />U Government Source U Industrial So urc <br />U Marine Source <br />A&S Environmental Services as the transporter of your TOTAL <br />haul your waste to a designated facility. <br />11 Hazardous waste may use another licensed transporter to CHARGES <br />DESIGNATED TSDF: U EVERGREEN <br />NVIRONMENTAL • 80 Smith Avenue • Newmark, CA • CAD982413262 - (800) 972-5284 <br />U RAMOS ENVIRONMENTAL • 151S. River Road • W. Sacramento, CA 95691 • CAD044003556 • (916) 371-5747 <br />0 RIVERBANK <br />IL TRANSFER • 5300 Claus Road • Riverbank, CA 95367 • CAL000190816 • (209) 863-8181 <br />U BEST ENVIRO <br />iMENTAL • 2430 Almond Drive • Silver Springs, NV 89429 • NVD982358483 • (775) 577-9001 <br />U ALTERNATE f <br />kCILITY <br />U ALTERNATE ACILITY <br />This is to certify that the above named articles a properly classified, described, pack- A service charge of 1 1/2% per month shall be charged on all past due accounts. Collections <br />aged, marked and labeled, and are in proper coi dition for transportation, according to costs, including attorney's fees, will be added to past due accounts placed for collections. <br />the applicable regulations of the Del artment of rransportation. I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER <br />WASTE, THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; AND THAT THE <br />WASTE DOES NOT CONTAIN ANY PCB'S. <br />DRIVER SIGNATURE <br />GENERATOR'S SIGNATURE AMOUNT DUE IN 30 DAYS <br />