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FREMOM EAVIRONMENTAL SERVICES, INC. <br /> Send Payment to: Phone: 800-559-3274 EPA ID#CAR000171017 <br /> P.O.Box 2875 Phone: 707-448-3700 U.S.D.O.T.#1484667 INVOI E # <br /> Vacaville,Ca 95696-2875 Fax: 707-448-3499 D.T.S.C.13544 <br /> www.hazwasteremoval.com CA#274461 Date .S l 1 C' <br /> SITE ADDRESS <br /> Customer D & H Auto Tech BILLING/MAILING AaCustomer UU 0cD'A H Auto Tech <br /> 720 E. Hammer Ln. 720 E. Hammer Ln. <br /> Stockton, CA 95210 Stockton, CA. 95210 <br /> E.P.A. # CAL 000 318 708 Phone _ Fax <br /> Phone Numbers: Office 209 951-1100 Cell <br /> Contact: CannonDenny - -- - - - -- - -_- <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 . 14 . 21 . 30 . 45 . 60 . 90 . 180 . 366 W/C WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) / CA 221 rip�£SLz Qu N L <br /> Non-RCRA Hazardous Waste Liquid(Used Anti-Freeze) CA 134 <br /> Non-RCRA Hazardous Waste Liquid(Oily Water) CA 223 <br /> Drained Used Oil/Gasoline I Diesel Fitters <br /> Norli Hazardous Waste Solid(0N Contaminated Debris,Sod} CA 223 <br /> Parts Washer Service CA 223 <br /> Non-RCRA Hazardous Waste Liquid(Brake Fluid) CA 343 <br /> Waste Flammable Liquid. N.O.S.,3,UN1993,PGII(Gasoline-Diesel) 331/1 <br /> Empty Drums Provide = Remove = 1 Al 1 A2 5g❑ 1 Og❑ 15g O 30g ❑ 559 O S P F <br /> Clor-D-Tect Q4000 Test Kit: Test❑ Pass❑ Fail ❑ Generator Knowledge$ PPM /Groti <br /> Transportati Charges/Additional Truck Time/Additional Labor/LAB Packing/Site Cleaning <br /> Clean: Y Labels Oi S(�, A/F Ai rl UOF f �=- Oily Debris N/ (¢- <br /> SERVICES REQUESTED BY TAX 1 8.00 <br /> We `� ter-•,' �' P. O.# TOTAL CHARGES: <br /> Acca T <br /> GENERATOR'S CERTIFICATION: I hereby der,cr.- aery aesv eed abme by proper sh pp�c barn,ono arm doss Cee.eockee,momee.ane <br /> posse,and are h all respects In proper co d'o^.[o.t �.g+ o J r 4 ..P,,,o e slate and nallanal government regu'ct[ons. III am a large ouant!ty,generate,I certify'hat, <br /> have o program in adds,d reduce rhe volume a'c tonicity of w.ve generated to the degree I have aelermined to be economically prcca ticass and that i nave selected the practicable method <br /> at nealment,floi,or disposal currenfly avo!obe tome which Mir mized the present ontl future threat to human health ana the envionmenl:OR ''I I am o small guantity generator I hove made <br /> c good birth effort to minin!ze My waste genera+ion ontl seli the best waste management method that Is available to me and that Can a'brd. All used oil from fie generetorlBted above <br /> will be harshened only to o frailty permitted by the state of Colitomia to produce used all into recycled at OR a facility that is required to comply with Federal regulations oppscobre to the <br /> management of used oil. All relevant informotron regarding known ersd,os ed hazards ossaciated with'ttls wash has been asclosee. the customer agrees to pay reasonable costs and attorney <br /> fees incurred in her collection of this collection. venue for u osse of this obli otion shall be!n Sotano Count declare untler perp: of u that the for oin !s tme and-.—at, <br /> DISPOSAL/RECYCLING FACILITY: �2oR93CtISrlStatlon Industrial AgricurtuI Govamment Marina Other I InduaslMal b atln <br /> �'bQRergrean Oil trr,-Di J I loo green Oil,Irc. ( J GEM Rancho Cordova LLC ( 1 BIg SRy Errvlronmebilal J ]21st Carkay EAI <br /> i 'm lRaed 3013 ORE03mi3Ave 118M YRge Rack Rd 4011 Cho"need 20M Newlands Or,East <br /> 1 Das,CA 95616 2 Newest CA 99693 Rancho Cordova,CA 95742 4 Bribers.CA 94510 5 Fernlay, N 85903 <br /> 10.7954409 CAD 932446874 510-795-W CAD98W418 916-36It980 CADM)88'4183 514591-21� 00=1639 Z71 <br /> D 338 <br /> 'ItRi <br /> t <br /> Lticlit� l <br /> 7 t! <br /> dnt Name �� Generator's Signature - > Driver''''ss Signature <br /> i State Law Requires that you keep this Receipt/Bill of Lading o/rille no less than 3 years. <br /> To Re-Activate or to eblain an EPA#-Customer may contort DTSC s 1-800-618-6942 <br />