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03/28/2007 09: 47 dulin accounting (FAXi19Z78Z9bJUb r. uu3iuu3 I y � eY Vl�A Vl�LL`NJG1�Y lt.G HVl�l•L`1Y1L`1\1 J Evergreen] Envir`,nental Services NO 359510 Jdedicofed to the protection of rile environment pp,, ��/�l�� .�/ To Scheduullee�a�pickup, call Send payment to: Sales Order #tL!J1l1L_LGLW 7 800-596-9455 Evergreens Oil,Inc. 6080 Smith Ave.,Newark,CA EPAa CAD982413262 P.O. BOX 30517 J 1 �S o.[ 16540 S.San Pedro St.,Carson,CA- riam CAD9aE413282 tns Angeles.CA 90030-0517- Date: ayL v GENERATOR/JOB LOCATION BILLING INFORMATION ME #, NAME j CASH[I CHECK ❑. l8` # AD SS .� L_Cj` V ADDRESS i - TOM l SO [ 6 ST "�P CO. CITY STATE ZIP CO. PO# PHO NO. � tJ PHONE NO. j PROFILE NO. CUSTOMER EPA ID NO. Q.— Off, 12, c ) i vvavb- ; 3Z I PRODUCT WASTE MANHtFS CODE N QUANTITY UNITS- PRICE AMOUNT Used oil,Non-RCRA Hazardous % Lubricating CA221 Gal. Q Iti' Waste,Liquid i Industrial CA221 Gal. u..a nn,n„.x;•,nw�l,wu.N�acnn xa..u� CA 134 Gal. wnmr �J VEE) IRQ"Wmn G,mloniMe`11::,Y05 NA Cn1r1 `'al, IY9J 111 nil om,unnnmeJ cilL hal [tl FaallFom I Oil Nr Water,Non-RCRA Hazardous Waste Liquid CA221 Gal. OAK 2007 Waste Solids and Sludges Gal. L Wash Our ` Each. aNry�U1-�E 'UUNIY Drained Used Oil Fllers - Thum Cy SERVICES Non-RCRA Hazardous Waste With(oily debris) CAM j Drum Empty Drums Drum Transporudion Non Hazardous Water - _ Got. Glycol Bulk 5W50 Gal. j Glycol Bulk - Cone. Gal. TEST:Q;Clor D Tach 4001i ppm Q Clor D Tech 10110 Q Posc Q Fail Q Halogen DerecmdFlame,Test ❑Pass Fail Field Service Work Description: Total Charges Other y. Other C6ti� Vacuum Services Time Our of Yard-On Site Off Site-Off Load Sum ff Load End Return to Yard TSDF onsolidated Mtfaifest vergmen Oil,Imo. E Env.Svc. Evergreen Env.Svc. L,� A1S Filler 6880 Smith Ave. R 306 4139 N.Valentine 15131 Clark Ave. . _ Newwk,CA 94560 Davis,CA 95616 - Fresno.CA 93722 ` Industry,CA 91745 CAD980887418 CAD982446974 CAD982446882 CAD000097432 EI Evergreen Eov.Svc. ❑ Evergrren Env.Svc. ❑CFR '❑ CFR ❑Greenleaf Env,Svc. awe San Pedro 745 A West Belleravia 944 E.Slauson Avc. 33210 Western 3474 Toyon Circle Carson,CA 90746 Santa Maria,CA 93454 Los Angeles,CA 90011 Union City,CA 94587 Valley S nps,CA 95352 CAD981696420 CAD992446858- CA1A00110021 - CAL000091587 CALOOD214411 O Collection Station El Genemmr certifies that it has established a program to reduce the volume or Source: quantity&maiciry,of die hazardous waste m the degree determined by O Marine ❑Agricultural 0"Industrial €eriennor to be economically l>ricticahre I hereby certify that I have read and have the authority to bind the above listed generator to the Terms on the reverse Retain sample # side of thls form. IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. Per California Health and Safety Code Section 25250.9,Evergreen hereby advises customer that customer's shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to management of used oil,but that is not required to comply with the more stringent rei)ulrements applicable to hazardous wwej management-facilitics,-California facilities that handle or process-tesed oil are required to meet those more stringent requirements,and some out-of--state facilities that process used oil also meet those requirements. These include more stringent leak'Idetection and prevention requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases It is lawful to send usedoilto cart-of-state facitaies that comply only with federal used oil martagemeraf standards 7 and not these more stringent requirements. This notification is for information purposes only. (� y' ��1 i j fU+ Dri Signature rine Name Route # to Generator's Signature -Print Name Date