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FREMOUW E#VIRONMENTAL ARVICES INC. <br />Ittcnt to: Phone: 8f}0-559-3274 EPA ID # CAR000171017 <br />875 Phone: 707 44$-3704 U.S.D.O.T. # 1484667 INVOICE # 2296 <br />Send Pad' <br />YKUPER SHIPPING DESCRIPTION <br />WASTE MANIFEST NUMBER QUANTITY UNITS <br />CODE <br />P.O- Box 2 <br />CA 221 <br />Vacaville, Ca 95696-2875 Fax. 707-448-3499 <br />D.T.S.C. # 3544 <br />www hazwasteremoval.com <br />CA # 274461 <br />Date `""/•'/1'CJ <br />I- � 1 &J n MCC Tpg6�% 's &d Customer R s . <br />Custome �' <br />717 <br />Address ? Zo �- Address <br />City _ftkkm State zip �47 City State Zip <br />E.P.A. #!! 4 Phone 04 9 / Fax <br />Phone Numbers: Offica ) AI vv Fax ( ) Cell ( ) <br />Contact: %7��f 6it� �. , E-mail: <br />rRvuut.1 - �tKVIC,r lNl-UKMAIIUN <br />Non-RCRA Hazardous Waste Liquid {Used Oil) <br />YKUPER SHIPPING DESCRIPTION <br />WASTE MANIFEST NUMBER QUANTITY UNITS <br />CODE <br />PRICE AMOUNT <br />CA 221 <br />Non-RCRA Hazardous Waste Liquid (Used AntFFreeze) <br />CA 134 <br />Non-RCRA Hazardous Waste Liquid (Oily Water) <br />CA 223 <br />V5 <br />Non-RCRA Hazardous Waste Solid (Oil Contaminated Debris, Sol) <br />CA 223 <br />Non-RCRA Hazardous Waste Liquid (Latex Paint) <br />Drained used oil / Gasoline / Diesel / Filters <br />CA 291 <br />N -A <br />Combustible Liquid, N.O.S., NA 1993 (used oil) III <br />CA 221 <br />Waste Paint Related Materials, 3 UN 1263, PG <br />Waste Flammable Liquid, N.O.S., 3, UN 1993, PG 11(Gasoline-Diesel) <br />Waste Aerosols, N.O.S. 2.1, UN 1950 PG <br />Empty Drums Provide Remove 5g ❑ 1 O ❑ 15g © 30g ❑ 55g ❑ S P F <br />Clor-D-Tett Q4000 Test Kit: Test ❑ Pass U Fail ❑ Generator Knowledge PPM <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 />GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fvlly and accurately described above by proper shipping name and ore classified, packed, marked, and <br />labeled, 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 t <br />have a program in place to reduce the volume and toxicity of waste generated to the degree I have detefmined to be economically practicable and that I have selected the practicable method <br />of treatment, storage, or disposal currenily available to me which minimized the present and future threat to human health and the environment; OR, if lam a small quantity generelor, I have made <br />a good faith effort to minimae my waste generation and select the best waste management method that is ava4oble to me and that I can afford. All used oil from the generator listed above <br />will be transported only to a faci€Ry permilied by the Slate of California to produce used oil into recycted oil OR a facility that is required to comply with Federal regulations applicable to fhe <br />management of used oil. All relevant information regarding known or suspected hazards associated with Ibis waste has been disclosed. The customer agrees to pay reasonable costs and attorney <br />fees incurred 'm the collection oft his obligation. Venue for purposes of This abligalion shall be in Solano counly. I declare under penalty of oe6ury thal the fornoino is true and correct- <br />DISPOSAL/RECYCLING FACILrTY: ollectlon Station Industrial Agriculture I Government I Marine Other ndustrtal Lvbrlcatinp <br />Oil Ofl <br />0 Garris Environmental Services Corp.eneral Environmental Mana emed, Inc. Onyx Environmental Services <br />P� 9 0 y ©Ramos t Ironmentd <br />535 Industrial Circle, White City, OR 97$03.3027 11855 White Rock Rd., Rancho Cordova, CA 93742 112S Hensler St., Richmond CA 44801 1515 S. River Rd, W. Sacromentor CA 95691 <br />541-830.1100 ORQ 000007781 916.351.0980 CAD 980884183 $10.233-8001 CAI ORD 014079 916-371.5747 CAD 044003556 <br />0 Coinmercid Filter recycling � r�I�kp_� Industrlai Oil © DK Dixon © Ofher <br />33210 Western Ave., Union City, CA 44587 L 1241 Laveme Ave., Klamath Falls, OR 97603 7300 Chevron Woy, Dixon, CA 95620 <br />510487.4227 541-884.9124 ORD 980980775 800-727-2874 CAT 080 012 602 <br />Generator's ai Pri t am rivers Slgnat <br />State Law Requires that you keep this Receipt/Bill of lading on file no less than 3 years. <br />To Re -Activate or to obtain an EPA tS - Customer may contact DISC ra 1-800-618-6942 <br />