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(,►qtr J&ov.. '* 8 a <br />WE ACCEPT vtSA & MASTERCARD <br />CLEARWATER <br />ENVIRONMENTAL MANAGEMENT, INC. <br />REMIT TO: <br />P.O. Box 2407 UNION CITY, CA 94587-2407 P.O. Box 349 SILVER SPRINGS, NV 89429-0349 <br />(800) 499-3676 FAX (510) 476-1786 (775) 577-9001 FAX (775) 577-9199 <br />CAR 000 007 013 NVD 982 358 483 (800) 471-2105 <br />BILLING INFORMATION <br />JOB SITE <br />Bill of Lading <br />Invoice #165597 <br />Date <br />NAME <br />NAME <br />PO# CASH CHECK <br />ADDRESS <br />ADDRESS <br />CUSTOMER EPA ID # <br />CITY STATE ZIP <br />CITY STATE ZIP <br />PROFILE # <br />PHONE NO. <br />PHONE NO. <br />CUSTOMER ID # <br />PRODUCT PROPER <br />WASTE <br />MANIFEST NUMBER <br />QUANTITY <br />UNITS <br />PRICE <br />AMOUNT <br />SHIPPING DESCRIPTION <br />CODE <br />Used Oil, Non-RCRA Hazardous <br />Waste, Liquid <br />221 <br />Used Automotive Antifreeze, Non-RCRA <br />Hazardous Waste, Liquid <br />134 <br />Oily Water Non-RCRA Hazardous <br />Waste, Liquid <br />Non RCRA Hazardous Waste Solid <br />Oil Contaminated Debris / Soil <br />Waste Combustible Liquid nos 3 <br />UN -1993, PG III <br />Non Hazardous Waste Liquid <br />Non Hazardous Waste Solid <br />Transportation Charges <br />Washout Charges <br />Drained Used Oil Filters <br />Empty Drums <br />Additional Labor <br />Pressure Washer <br />Other: <br />DISPOSAURECYCLING FACILITY: Collection Station Industrial Agriculture Government Marine TOTAL <br />Alviso Independent Oil Clearwater Environmental Mgmt. Inc. D/K Environmental <br />5002 Archer Street; Alviso. CA 2430 Almond Dr. 3650 E. 26th Street; Vernon, CA <br />CAL 000 161 743; 95002 Silver Springs, NV 89429 CAT 080 033 681; 90023 — <br />(510) 476-1740 NVD 982 358 483 (323) 268-5056 <br />(775)577-9001 <br />Onyx Environmental Services r ------- I Seaport Environmental Commercial Filter Recycling <br />1125 Hensley Street; Richmond, CA 675 Seaport Blvd; Redwood City, CA 33210 Western Ave; Union City, CA <br />CAT 080 014 079; 94801 CAR 000 140 624; 94063 (510) 487-9227; 94587 <br />(510)233-8001 (650)364-8154 <br />DeMenno Kerdoon Evergreen Oil <br />2000 N. Alameda Blvd; Compton, CA 6880 Smith Ave; Newark. CA <br />CAT 080 013 352; 90222 CAD 980 887 418; 94560 <br />(310) 537-7100 (510) 795-4400 <br />I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of the waste. All relevant information regarding known or suspected hazards <br />associated with the wastes has been disclosed. I certify that we have an established program to reduce the volume of waste to the degree to be economically practicable. <br />DRIVER GENERATOR <br />SIGNATURE SIGNATURE <br />