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2098324259 0,''17:44p.m. 05-05-2010 9114
<br /> WORK ORDFIIZ/,-,.,-RV ICE, .1(,RE.E MEN'F
<br /> Evergreen Environmental Services No 4216548
<br /> dedi(aled!n file pi-e),fel-twil n(t(u envir•um)new
<br /> "- To schedule a pickup, call Send payment to: Sales Order
<br /> 800-596-9455 Evergreen Oil, 1111'.
<br /> 6880 Smith Ave..Newark,CA EPAP CAD982413262 P.O- BOX 30517 7
<br /> 16540 S. San Pedro St.Carson,CA. EPA#CAD982413262 [_tri Arigs les. CA 90030-0517 Date.
<br /> GENER 1'F()WJOB LOCATION BILLING INFORMATION
<br /> INAME
<br /> #
<br /> ADDRESS ,%T)I)RFS5 CCES1TUIER CODE NO.
<br /> T r r
<br /> CITY STAT ZIP Co. CITY ti'fWF ZIP
<br /> �PIIO< N[: O. PHONE NO. PROFILE NO. —..--_ (:(S't'Ol41ER FPA 11)�i4.
<br /> _ WASTE '<IANIFEST^!QUANTITY t'ITY (;NITS � PRICK A.%IO iNT
<br /> PRODUCT CODS, NUMBER
<br /> Used oi!. Min-RCRA llazartk)us Luhricating CA„h E t_,-,-•,trs' Gal.
<br /> �- htdu,trial
<br /> Waste, L.iyuid CA221 Gal.-
<br /> t:,e,f At,n,u:,uit,•-u,;iliro,l•.�.,n.et RA u:,r.::,lev. CA 134 C.i'tl.
<br /> 14' N ,.,.f.0,enl .. —.-------- J--'
<br /> RQ.v ,,t'.,,,,nu,:,t,tr t.rya,J.mtrs tin w (::t"t Gal.
<br /> I1N{111 t-I 1r„rta,i,iliilyd,.�i,!,:.—hal�.:,�,7_...•..,.—,...„..,....__,_..-...-.- r'(Af
<br /> Oil K Witter, tinn-RCRA Hazardous Waste Liquid Ciul��
<br /> Waste St,lids:md Sludges
<br /> Each
<br /> Wash Out
<br /> Drum
<br /> Draine{I l.ised Oil Filter
<br /> Non-RCRA liacarduus Waste Solid,t,lily debri.) CA22 i - - � Drum -
<br /> " Drum
<br /> Empty Drums �----_.
<br /> Transportation -�_. _-l•.••••--•---.-
<br /> { Cir..
<br /> I Ciill.
<br /> Nun Hatardutu Water _-- _ _ ---
<br /> Glycol Bulk tial. -
<br /> Glvcol Bit ti Conc. Gal. i
<br /> TEST:Q C•ltfr D Tech 4(x10,,._..' Ppm ❑Chir D Tech I()I)00 Pal-❑Fail f7,
<br /> lial,n en t)euctorli lana Petit ❑Pa>s ❑ fait k}
<br /> Total Charges
<br /> Field Serf ice Work De,011)1iun:
<br /> Other: l_..� —_ ...............
<br /> s
<br /> ..............._...
<br /> Other
<br /> _.........._.-.......-.J _.................__.................... ......
<br /> Vacuum.5crvit:es l-in:c d -----
<br /> Out ot`Yur 1 On Sile--()It Sitcom OI•t'Ijosd Sia-- t� �- :”t)sf L.n;td find Return iil Yard-� --t
<br /> TSPS ' &nsolidated Manifest
<br /> ri Fter!trccn{)i!.[tic, litirrefecn tilt+.S+t'. (-1 Fitcrertc!Kl.t•.Sec. \is Filter
<br /> !-r (�lRl1 yrntth.15 c. L1 Ri'mi'10H i? t`i?1 Clark t+c. Tu��
<br /> \c11;u•t..(-:\')a'thtI 1.);n i,.C':\'ht'ilh l rc,na.C-t 1137" Int)tt,tr•..C A 91'45
<br /> C`\I.)`i l)titi?4i\ ( •tIY)C 11hS71 (` -
<br /> 5 1' (TR (iit'l nit':tl F m i11.
<br /> I:1erc<acnf?u1. S-:
<br /> i I •li.11" S!:u::'n t••r.
<br /> _1 ir,N)4'i. !>:.U,; .t ;t:,,t R.'tia'.t;r_: ...._ 11 1'1,'1 t';t1 t'
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<br /> i ( \l a)4 a.al.h.�
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<br /> ult
<br /> _............._._ --................;_................................. .t r:'I 1 +
<br /> {) &t':::.n1 .1I dSi !S.S J!':I,xu, :1.:.t:„ !tt,_.ic r„a•!,t+lnii;lt 15:
<br /> tlrce'.
<br /> .,!+c..i n!tn!ill',ii l` 111•'"r't"<i
<br /> _] !t trFlu 1_rltukttlrlli �I tll...ltl�..i7�li
<br /> j.'..` ........_..-.__._.................................._..........._................................. I tereh� tertity—that_ fi►.t4_.....-re.}cE sn[!.._.m-e. Fhb.......... ritt'_tn
<br /> hitsd tile aboli( listed...l;ener.}tt)r to t11c.,trrnt„ui1 t.(._1111 r+e
<br /> Ade of lhis flail.
<br /> Retain sample #.....::_....._.-.___. -- _........... ....-................_._....................... --_..........----------
<br /> INIPOR'I'ANT NOTICE REG kRDING THE DISPOSITION OF YOUR OIL
<br /> per t'alil'nrtliat I-lealth and saretit Code section 2;2;40, i 1:'r richt 1tt'n:11 :!tlti,i, .:u,;,tr.tcr tit:t ill tc,r?,Lr`, -hit?11;(!11 ,1! ?1• t; „rl Ilia\ lic
<br /> :i,!cua>, .s" i :hi .!t.,n<: i1t!i[?: ,t;;r-c11 ,il, hti4 t'i.lt r•. it<1r itiulriti tit
<br /> 2 l a ,tt llslk th;ri 1, rclluit'etl
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<br /> lilt[{?it ,.itfi
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<br /> tv ,,n i, n1� :1 'illi ..cit{>}' i't?;d i1!•:4.t'„ •<it, .I .Il,u !1'.it ,,. -
<br /> t+i • li ,: , ,rli � r, rtyr:[trnti!1t a:r.[ 11 i71; c![i! .! I . i 'i ' :
<br /> , 1'„r
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<br /> 13'iit1111 Ilh'r, +I. Ittilll . .<11; .11111 i :.•1'I!lt ;t' Ui!''(tlit'i1?,. :. .' `
<br /> .•. .' ; tt: .,5r� tl� t.!tc .:�t t�!r l;;, i°t:ii .;1'+11 '!li\ a!ltt :'caiir:li lt,t:<l :tl n`.`.I t',r1;:I'itl'til �:l pllti;tl'1f,
<br /> + ':
<br /> .!till [list t1K':Q !12,'1'. +E 3'?!i'.: lit :ia!li llli tll, 1125, n,s•.il!,.:.itH`.!! !, ,<:I' tntn;'n L1t I: 't Jtth''7„ < .t>t:
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