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J INVOICE <br /> '* peS" f" , 94e&A Rw#&tf 103908 <br /> Q <br /> _ frf SWAkMM •N.KV ✓�W�.ae, Manifest#1 1 <br /> 1922 W. Belmont Ave.• Fresno, CA 93728-2626 <br /> EPA#CAL 000102751 <br /> 535 (559) 498-0240 • Fax (559) 498-0256 EPA# C P,Q. t)C,r a 1'IgZq <br /> [AME <br /> DELTA TRUCK CENTER DATE _ O HALIDES FADS <br /> DDRESS P.O.# <br /> 10182 S. Harlan Rd. <br /> TY French Camp sT� ZIP 95231 RH X83-2400 <br /> PRODUCT • • SHIPTOr. <br /> NON-RCRA HAZARDOUS WASTE ❑ Clean Harbors-Budoovw0ow <br /> USED OILIMIXED OILS STATE CbDE 221 2500 West <br /> CA 93206(661)762-6200 • <br /> NON-RCRA HAZARDOUS WASTE, LIQUID ❑ Padar,cA9 E.Manning <br /> USED ANTI-FREEZE) STATE CODE 133 <br /> -USED OIL FILTERS ❑ McKttnck, 548 <br /> CA sz5i7ss18jifiz136s.. <br /> BARREL �d}"` d, N v°e oav!'o'r I(32&2E8501 <br /> o� OD A.J.S.Rker-15131 E.Clark 41'616w` - <br /> ` 'S' ❑ Industry,CA 91745 (626)333-5 7: ' <br /> WASH RACK Siemens Water Technologies Corp <br /> OTHER ii� O�Q\ C DiC OO V rnon,CA 90058 (323)27]-1500 <br /> PLEASE PAY FROM THIS INVOICE TERM• NF:T DAYS r oO pa ❑ Alternate facility: <br /> 1.S/.INTEREST WILL BE CBARCCB RFTER N BAYS.InIheeremdJutlivlalpmosdj sloenlorve oeeNo�a, p swill Le Lahle rallammeasolmllaion. <br /> If am a lag e uantity generator, I certi that I have a program in place to reduce ' IMPORTANT NOTICE <br /> 9 9 fY REGARDING TIRE IMPORTANT <br /> OFUIYODR USED OtF '- <br /> -the.volume and toxicity of waste generated to the degree I have determined to be ;'PLEASes1GN.AEnr READG, <br /> '- economically practicable and that I have selected the practicable method of San Joaquin Filter Recycling(used odtanspoder)hereey advises <br /> treatment,storage,or disposal currently available to me which minimize the present (used oil generator)the generators shipment of used oil may be <br /> and future threat to human health and the environment;OR,if I am a small quanfity transported fo aremgry n,ar�s agwrea m¢ompry w,'Bh tedea regu rations appuramem managemem or used oil,dunnis is <br /> generator, l have made a good faith effort to minimize my waste generation and not rammndtecomply win me more smngerkregdtremenls apgamem hamrdonswte managerroutfcgmds.Columbia <br /> - select the best waste management method that is available to me and that Lean facilities that handle m-pracess a oil are regmred to meatthase more stringent requirements,and some out-of-slate <br /> afford. facilities that process used or also required meet these requirements.These include more stringent leak detection and <br /> prevention requirements engineering.certifications of tank integrityand financial assurances for closure and accidental • <br /> 1. •I HEREBY CERTIFYTHAT I HAVE NOT MIXED THIS WASTE WITH NY OTHERWASTE, releases Its lawfultos dusedoil to am of state iacilieesthaimmply only witty tedeal us¢tl ail managementstandinds <br /> THATTHETOTAL HALIDES ARE LESS THAN 1000 P.P.M.;AND TH THEWASTE DOES and muthesemorestimuntimpnrmnta. <br /> -..NOT CONTAIN ANY P.C.B'S.. This notification is for information only purposes only. <br /> r I FURTHER AGREE TO ACCEPTTHE ADDITIONAL CHARGES FOR LEGAL DISPOSALIF THIS WASTE IS (signed,Transported Date: <br /> �.'... 'OVER 1000 P.P.M. TOTAL HALIDES,OR CONTAINS ANY P.C.B'S. r{ "—' signed,Ganeawr) Data: <br /> This is to certify that the above named articles are properly classified,described,packaged 'do, are in - oper condition for transportation,ac orcji j to tire applicable <br /> re s for the Department of Transportation. '/�� <br /> � - <br /> DRIVER SIGNATURE GENERATOR'S SIGNAMRE - PRINT NAME <br /> THIS DOCUMENT MUST BE KEPT FOR AT LEAST 3 YEARS <br />