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2011-Feb-11 02:10 PM DSW AG �209-3�';-8867 2142 <br /> J r. 5803b r <br /> Evergreen E' viro>rYmentaY Services <br /> +My dt•dir<rrrrl nt Itr pr»rur7i.,u rr/t!u't'rrl•inrrtrttYnr �,dy <br /> To schedule PiCkUP, Call . •., '! SaleOrde1' <br /> 800-59 -9455 Evergreen Oil,Inc. <br /> Dept,LA 23334 <br /> nxxtl Sn.i,t,Ave.Nrwnrt.•t•A HI'AA' 'ADVK2au7.r,_ CA 911,45-3234 <br /> Date' <br /> th3411 5.5at11't!drn at..c:ui.",�,.C'A f PAa C'AUlttt?.dl 3201 BILLING INFORMATION <br /> GENERATOR/,IOB LOCATI N NAME CASH ❑ CHECK❑ <br /> N A F. # <br /> ADDRESS C' •TFf Uc' <br /> ADDRESSr b <br /> CITY e <br /> TATE. P� 'U. CITY S TI: ZIP CU. [v0 N <br /> PHONE NO. PROk'II,E NO. U T MLI FTA ID NO. <br /> WASTE MANIFEST QUANTITY UNITS PRICK, AMOUNT <br /> PRODUCT CODE NUMBER <br /> Gal <br /> UscJ oil.Non-RCRA HttsantuuK Lubricuting CA2' 'L J Vat. <br /> Wiwv,Liyuid tndu rlol CA331 <br /> G.nl A,dumntiry nndfrva4,trnn-R('ttA,Ivanb„ <br /> CA 134 Go►. <br /> w,. Li,Uid �.\+�jI Gal. <br /> py/uylQ Qunl,umlblr l.i,wld.N.0.6.N.[ hTKll/jh NII <br /> µr 1l rna mn minotctl wkh hck. AwlGal. <br /> oil&Watar,Non-ttCRA HnrardnuK ante Liquid CA223 Gal. <br /> Non Huzarduus Water Gal. <br /> Wattle solids and Sludges Each <br /> Wush Out Day <br /> preKsurc Washer/Steam Cleancr <br /> rs. <br /> Transportation % <br /> Fuel Surcharge Gal, <br /> Glycol Bulk SN specify Product Gal <br /> Giycni Bulk .onc,lSpecify Product�� <br /> TG.ST: Clor D Tech 4txl(Y� <br /> •�fpm <br /> �� ❑Clor D Tech I Otto Pass ❑Fnil <br /> p - - - — —_--- -- <br /> ReI.1 111 Sample # . <br /> Field Service work Description: <br /> Other: <br /> other: -.�./`^ � <br /> TSD Consolidated Manifest 1)K1�'!`:lt ('lff'• <br /> Uit,Inc.-t�wis Evergreen oil,Inc.-Fresno <br /> vergn:en A Inc. Ll E ❑ 4139 N.Valentine i ,.. t: • I 1 <br /> 688n Smtth Ave• lJ D 3t)A <br /> Ncwnrk.CA 1145mu b vls,CA 9561 R CA D9 4 43723 , <br /> ('AD9M0'h874l8 C )9R2446874 CAD9M1a468R2 <br /> r1 l:vergncn Env.Sv i c7iLllr,•5euatvt�+a� -- <br /> l_1 {mina S.tion Ped 7 5 A West Betteraviu <br /> C'uraon,CA 9117 <br /> S ntu Muria.C'A 9.1454 <br /> C A 8169 AD982446959 Generatur cortitleK that it has established u prngntln ur n duce the volulnc ur <br /> Source: Collection (tatlon ❑Govemment b nierninr&tothc ccononillcally pneticubleus Le 1`l the degree dctenninud by <br /> ❑M�uine I] A ricultural IlldllStIlal to <br /> r rtt?V that i have reA� And hny h <br /> _ .,. tt,�to.ma nn the er verxe <br /> steel '-" <br /> r.n rna .v`w _-- <br /> side of this o m. <br /> IMPORTANT NO'T'ICE REGARDING THE DISPOSITION OF YOUR OIL. <br /> 5 'Evergreen hereby advises <br /> oushipment � \ <br /> Per CaliforniaHealhndatyCcumuttugcmcntf used oil'btthat is not required to <br /> Irunspnrted It)11 <br /> tY Sfed!n comply with reulationcappll�tble t <br /> ndle or <br /> to,hazardou:4 <br /> te <br /> ies.Ca <br /> comply"f th the <br /> tntnteottrillsetntt re stringentsreyuir�vent anti same. <br /> rat I tticsathuttprcxcastused <br /> t'`ttal`ntmeet thhse requirement.,;. <br /> vt <br /> tail ort:req <br /> Wit rut sod nil management standards <br /> fhcs Its luta( mvle stringe„t lea tlrtectitrn and prevention rettuirements,engines clog certifications of funk i riry,and`...... u5curanecs o <br /> clns Itnd at CICtCtUsl rClLilxcS. I lA iA\vtlll tn'5dlld ttsetl OII t0 OUt�f'S1�td fd�IIIt1C5 Mal CVlllp�y only <br /> and;ver <br /> these more stringent nx itim-ments.This nntiticatiun it for infonnutitan putpnscs only.Signature t Name twte# <br /> Date ner gnature Print Name Date <br /> r'nnu Nink ii Yi+d:tw.r'.rlf:V'-{)illCt:i),0'G1 E,(�!l.u{? Ilacrl'o m7n�I0t;t r."inlricn Coity^17rIVNf I',oPV <br />