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209 832 4259 OP 111:49 p.m. 05-05-2010 12/14 <br /> WORK ORDERP�ERVICE AGREEMENT <br /> Evergreen Environmental Services No- 390172 <br /> Send Paymelif to., 0� to <br /> Toe schedule a pickup, call Sales Ordcl. <br /> 800-596-9455 ' Oil. Inc. <br /> 68,90 Smith Ave. Newark.CA SPAM CAD982413262 PJ;. M.-A 10517 13 Z7 <br /> =6540 S. San Peeirr,St.,Camon,CA EPAU CAD9824 13262 Leis Allgklcl- CA 9M.w-oi I-, <br /> P WPM LOCATION BILLINK; INFORNIATION <br /> I.-I.............. ............ <br /> ------- ....... -.._.....-T'—,- CASI I MCK <br /> NAN I I. NAME j <br /> ............ #, <br /> U ;S <br /> ................ JW-('.'ODE No <br /> m)DRESS <br /> ZIP # <br /> z CITY si'va <br /> ............ ............................. <br /> T-;.-6-.......................... <br /> PHONE NO. (TS]'ONIER EPA 11) NO, <br /> ......................... .................................. <br /> ..f- I------------- <br /> ............................. <br /> -MANIFEST UNITS I <br /> PRODUCT OUANTITY ANIOUNT <br /> CODE NUMBER <br /> 1:11111 LtIl. NowRCRA fbzm-doti, ImInliv;i1illi., CA-221,�k ..................r .................. <br /> ........................ ...........- <br /> Wnslc, Liquid hnlu,lnyl 1'A221 Gill. <br /> CA 1.14 Gill..—J . ...... <br /> ............... <br /> tl <br /> RQ .................... <br /> ................... <br /> 1 P, -21-1d- <br /> Gi 1. <br /> (Mec Walcr.Noii,RCRA lb/arLiotli livame I�hjtlid CA221 <br /> bb w,le Solidk and <br /> \Vn,;h Out <br /> Drained U,od oil Filwr,, <br /> w.o,!SoIjkl,ioilyjehl CA223Drum <br /> - <br /> ............ <br /> Gill. <br /> ------------ / Gal............ ....... <br /> 1 tial. <br /> ....................... <br /> Glycol Bulk C-1c. I <br /> DI'Ml-IM0.7.3op-ppol CorD'I'cx-h 141104- <br /> Fn S r:: C1,,I 1./Pa- <br /> -T-7Mal <br /> �-,—1 -- t Chaj-,!es <br /> [it Sej-%icc W,It I, DL�,Cf ip <br /> ............. <br /> . ..... <br /> ......... <br /> ---------- <br /> ----------- ------- <br /> 00 t.tiad Eild .................... /P� <br /> Oill. If '51-d )it S:Eo 1pl Sit,:........... 011'1;1311 Slaff <br /> ............... ......... ......................................................... ............... <br /> ........................... .......... /,,. - <br /> Consolidated N-hinifest <br /> ---------- <br /> Oil.Inc US I:iit,:r <br /> 1 .,l",;N %.A;Itizle <br /> it ........................ <br /> ............. ................ <br /> ............... <br /> ............. <br /> . ........................ .................................. <br /> 'A ...... <br /> sm:n, <br /> j Govel-11 I I lent A� '"I'w <br /> j <br /> lbal I have rcad jind hale the authority to <br /> 'dal ille' <br /> ........................... t -..find................................................... <br /> ............. .................................................. erchii C .............................. <br /> .................... <br /> Ijilld Ile ;11)t)ye listed jellMor erto the terms on the reverse <br /> I.........-...........-I.......... .............................................................. <br /> Retain sample # id e of I 1 1 1 s forill. <br /> .. ...... .................. ........... <br /> REGARDING THE DISPOSITION OF NorR 011- <br /> 11PORTANT NOTIC1, <br /> ;0,9. 111 It I' I h�l! k I I-wl 'i 1!PfliVOI ;,t I ,:J Ill mx% N: <br /> Iler Califortiia Health Mild .haft'" 00V Secti(t 252 <br /> -\tih ih� Illi'lv 2ot! <br /> 'tiLl I <br /> tit <br /> i'tA <br />