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CLEARWATER <br />ENVIRONMENTAL MANAGEMENT, INC. <br />REMIT TO: <br />P.O. Box 2407 UNION CITY, CA 94587-2407 <br />(800) 499-3676 FV (510) 476-1786 <br />CAR 000 007 013 <br />BILLING INFORMATION <br />WE ACCEPT \t. .-A 8: MASTERCARD <br />P.O. Box 349 SILVER SPRINGS, NV 89429-0349 <br />(775) 577-9001 FAX (775) 577-9199 <br />NVD 982 358 483 (800) 471-2105 <br />JOB SITE <br />Bill of Lading <br />Invoice # <br />Dates 7a" - <br />NAME ! <br />NAME <br />PO# CASH CHECK <br />ADDRESS <br />ADDRESS <br />CUSTOMER EPA ID # <br />Oo <br />ITTATE <br />Y# <br />ZIP <br />CITY <br />STATE ZIP <br />PROFILE # <br />PHONE <br />PHONE NO. <br />CUSTOMER ID # <br />OD CT 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 />UN1993, 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: <br />Collection Station Industrial <br />Agriculture Government Marine TOTAL <br />Alviso Independent Oil Clearwater Environmental Mgmt. Inc. <br />Q D(K Environmental <br />5002 Archer Street; Alviso, CA <br />2430 Almond Dr. <br />3650 E. 26th Street: Vernon, CA \/ <br />CAL 000 161 743; 95002 <br />Silver Springs, NV 89429 <br />CAT 080 033 681; 90023 - - <br />(510)476-1 740 <br />NVD 982 358 483 <br />(323) 268-5056 <br />(775)577-9001 <br />Onyx Environmental Services Seaport Environmental <br />Commercial Filter Recycling <br />1125 Hensley Street: Richmond, CA <br />675 Seaport Blvd; Redwood City, CA <br />33210 Western Ave; Union City, CA <br />CAT 080 014 079; 94801 <br />CAR 000 140 624: 94063 <br />(510) 487.9227; 94587 <br />(510) 233-8001 <br />(650) 364-8154 <br />DeMenno Kerdoon ® Evergreen Oil <br />2000 N. Alameda Blvd; Compton, CA <br />6880 Smith Ave: Newark. CA <br />CAT 080 013 352; 90222 <br />CAD 980 887 418; 94560 <br />(310) 537-7100 <br />(510) 795-4400 <br />I hereby certify that all information submitted in this and all attached documents c n true and accurate descriptions of the was . All -levant information regarding known or suspected hazards <br />associated with the wastes has been disclosed. I certify that we a an a lis d program to reduce the volume of waste to t e egree i be economically practicable. <br />DRIVER GENERATOR <br />SIGNATURE SIGNATURE <br />