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FREMOUW EOVIRONMENTAL ARVICES, INC. <br />Sell (I Pay 1r1ent to: Phone: 800-559-3274 EPA ID 19 CAROOpl71017 <br />PO- Liclx 2$75 Phone: 707-448-3700 U.S.D.O.T. # 1484667 INVOICE # 222 <br />VacliVille, Ca 95696-2875 Fax: 707-448-3499 D.T.S.C. # 3544 <br />www.hfLzwasteremoval.com CA 4 274461 Date 9 �� V <br />-f 911 r b1LLJr ,/NLAILING FSS <br />Costo rr G V Customer <br />Address UCom. f <br />_ Address <br />l �., . -- <br />C <br />E.P.A. # <br />Phone Numb <br />Contact: J` <br />Zip <br />�) 00 Fax <br />Lf <br />PRODUCT - SERVICE INF <br />Non-RCRA Hazardous Waste Liquid (Used Oil) <br />Non-RCRA Hazardous Waste Liquid (Used Anti -Freeze) <br />Non-RCRA Hazardous Waste Liquid (Oily Water) <br />Non-RCRA Hazardous Waste Solid (Oil Contaminated Debris, Soil) <br />Non-RCRA Hazardous Waste Liquid (Latex Paint) <br />Drained used oil / Gasoline / Diesel / Filters <br />Combustible Liquid, N.O.S., NA 1993 (used oil) M <br />Waste Paint Related Materials, 3 UN 1263, PG <br />Waste Flammable Liquid, N.O.S., 3, UN 1993, PG II lGasoline-Diesel) <br />Waste Aerosols, N.O.S. 2. 1, UN 1950 PG <br />Empty Drums Provide Q Remove <br />Cell ( } <br />E-mail: <br />AT_ ION/PROPER SHIPPING DESCRIPTIOW <br />MANIFEST NUMBER <br />CA 221 <br />CA 134 <br />CA 223 <br />CA 223 <br />CA 291 <br />N -A <br />CA 221 <br />5g ❑ l Og ❑ 15g ❑ 30g ❑ 55g ❑ S P F <br />Test Kit: Test 9 Pass IV Fail ❑ ❑ few <br />Transportation Charges/Additional Truck Time/Additional Labor/ LAB Packing <br />Additional Equipment Supplies <br />Hazardous Waste Labels <br />Used Oil Disposal Fee <br />Other <br />P. O. # <br />Tip <br />QUANTITY <br />UNITS <br />PRICE <br />AMOUNT <br />=9 <br />TOTAL CHARGES: <br />TAX <br />GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment ore fully and accurately described above by proper shipping name and are classitied, packed, marked, and <br />labe3ed, and are in all respects In proper condition for transport by highway according to applicable stale and national government regulations. It I am a large quantity generator, I certify that I <br />have a program in ptace to reduce the volume and toxicity of waste generated to the degree I have determined to be economically pracficabfe and that ! have selected the practicable method <br />at treatment. storage, or disposal currently ovcloble to me which minimized the present and future threat 10 human health and the environment; OR, if I am a small quantity generator, f have mode <br />a good faith effort to minimize my waste generation and select the best waste management method that is ovo4able 10 me and that I can afford. All used oil from the generator lisled above <br />will be transported only to a facility permitted by the Slate of California to produce used oil into recycled oil OA a facility that is required to comply with Federal regulations applicable to the <br />management of used oil. All relevant information regarding known or suspected hazards associated with this waste has been disclosed. The cuslomer agrees to pay reasonable casts and attorney <br />Sees incurred in the collection of this obi alion. Venue for purposes of this obligation shall be in Solono county. I declare underpenallyalu that the forgoing is true and correct. <br />L___J varus mvnonmentas Sehlces Corp. General Environmental Management, Inc. Onyx Envhonmental Seiv€ces <br />53S industrial Circle. White City, OR 97503.3027 11855 While Rock Rd., Rancho Cordova, CA 95742 tal <br />f !15 Hensley SL. Richmond CA 94801 Ramos s River Environmental <br />n Sacramento, CA 9$691 <br />541-830-1100 OR0000007781 915351-0980 CAD 980884183 $10-233-8001 CAT 080014079 916-371.5747 CAD 044003555 <br />0 Commercial Niter RecycBng Industrial Oil DK Dixon ©Other <br />33210 Western Ave, rdon City, CA 7 , 1291 Laveme Ave., vornath fans, OR 97603 730D Chevron Way, Dixon, CA 95620 <br />510.487-9227 541.884.9124 ORD 980980775 800-727-2879 CAT 080 012 602 <br />Gener s 5i lure rMt Name Dn ig ature <br />State Law Requires that you keep this Receipf/Bill of lading on file no less than 3 ye m <br />To Re -Activate or 10 obtain on EPA N - Customer may contact DTSC is 1-800-618-6 <br />