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FREMOUW ENVIRONMENTAL SERVICES, INC. <br /> Send Payment to: Phone: 800-559-3274 EPA ID#CAR000171017 CSLB A-Eng#1022665 <br /> i 6940 Tremont Road Phone: 707-448-3700 U.S.D.O.T.#1484667 Small Business#56427 INVOICE # <br /> Dixon,CA 95620 Fax: 707-448-3499 D.T.S.C.#3544 <br /> www.hazardousdispasal.net CA#274461 Date <br /> SITE ADDRESS BILLING/MAILING ADDRESS <br /> Customer Customer <br /> gy; <br /> "'S'C+I A <br /> �"1r r+. i IT1 ifsb <br /> E.P.A. # Phone <br /> Additional Contacts: PAYMENT TERMS <br /> PRODIJC'I -SrP.VICE INFORMATION/PROPER SHIPPING DESCRIPTION/BILL OF LADING <br /> 7 14 + 21 + 30 + 45 + 60 90 180 + 365 W/C WASTE MANIFEST NUMBER QUANTITY UNITS PRICE <br /> CODE <br /> i <br /> f i r i <br /> I <br /> 4°GP1\/1 P�ICP A9�P�IICPT[F9 ION I�-*� <br /> JLI\YIiiLJ IiLi;V LJILVI�I <br /> We <br /> Accept P. O.# TOTAL CHARGES: <br /> GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed,i <br /> labeled,and are in all respects in proper condition for transport by highway according to applicable state and national government regulations. if I am a large quantity generator,I r <br /> have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the pract <br /> of treatment,storage,or disposal currently available to me which minimized the present and future threat to human health and the environment;OR,if 1 am a small quantity generate <br /> a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford. All used oil from the generator Ilste <br /> will be transported only to a facility permitted by the State of California to produce used oil into recycled oil OR a facility that is required to comply with Federal regulations applicable <br /> mcnagcmcr-1 0;"�Ca oil. All fees incurred in the collection rot this obit atlon Ven a for y u ores of this obligation shall be in Solana county. I declare under penaltyofperjury that rhe <br /> forgoing. is true and correct <br /> DISPOSAL/RECYCLING FACILITY: Collection Station Industrial Agriculture Govemment Marine I Other Indussltrial <br /> I hereby certit that I have read and have the authorliy to <br /> bind the above.ijsted generator to the terms on fe <br /> reverse side of this.1 <br /> .. —� gtnfa I mnr RPnuirrae that voukeen this Receiot/Bill of Ladino on file no less than 3 Years. <br />