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C L EA R WAT E R ` r Bill of Lading <br /> ENVIRONMENTAL Invoice # , r �4 <br /> MANAGEMENT,INC. <br /> P.O. Box 7420 a Fremont,CA 94537-7420 Date Q <br /> (800'29-3676 9-3676 a Fax(510)744-9341 +r <br /> 4 <br /> BILLING INFORMATION JOB SITE ; <br /> NAME NAME , CASH CHECK <br /> # <br /> ADDRESS ADDRESS CUSTOMER EPA ID# <br /> 4 Z-�-�O� <br /> CITY STATE ZIP CITY T TE /IP PO# <br /> PHONE NO. PHONE NO CUSTOMER ID NO. <br /> ( �7 ' <br /> PRODUCT WASTE MANIFEST QUANTITY UNITS PRICE AMOUNT <br /> CODE NUMBER <br /> Oily Water Non RCRA Hazardous 221 Gallons <br /> Waste Li uid. <br /> Used Oil, Non-RCRA Hazardous Gallons <br /> Waste, Liquids 221 <br /> Used Automotive Antifreeze, Non-RCRA Gallons <br /> Hazardous Waste, Liquid 134 <br /> Non RCRA Hazardous Waste Solids Drums <br /> Oil Contaminated Debris Jt <br /> Non Hazardous Oily Waste Li uids N1A Gallons Z 4 <br /> Drained Used Oil Filters Drums " <br /> Transportation Cha es Hours <br /> Washout Charges <br /> Em t Drums <br /> Other: <br /> DISPOSAURECYCING FACILITY: I hereby certify that all Information submitted In this and all attached documents contain true and accurate <br /> ► J descriptions of the waste.All relevant Information regarding known or suspected hazards associated with <br /> Ex!T"-- the wastes has been disclosed. This further serves as notification that pursuant to Title 22, <br /> Section 66268.7(a)(10)the above tfsted wastes are banned from land disposal. <br /> �, ' GENERATOR - TOTALS <br /> 11t /f!, i, / <br /> J /r DRIVE l.%✓� SIGNATURE " f <br />