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2011-Feb-11 0210 PM DSW AG 209-339-5867 5/42
<br /> Evergreen E>r>t�iln0 Se �.,W RK ORDER. ;RVXCE
<br /> Evers nmenta tliMA AE �iui
<br /> E <deditYlled to thsl pagerlloll offhe envimalnent N� I
<br /> f.
<br /> - To schedule a pickup,oafl Send Wuymer<t tu: '
<br /> 800-5961-9455 Sales Order
<br /> Evergreen Oil,Inc,
<br /> 6880,SmithAva,.Newark,CA EPA+r Ca 9824]3263 Dept.LA 23234
<br /> 16-'40S,San Pedm St.,Carnan,CA L'PA#CAD992,117262 Pasadena,CA 91185-3234 Date:
<br /> �is1t } � 1.•'
<br /> EIYEIiATORIJOB LOCATIO `
<br /> rW ME
<br /> STI.LING INFORMATION ,:rect?K ttr4'r,` j;f1�"S t;` �`•'
<br /> F NAME CAS
<br /> KESS. ADDRESS # ©flip?'
<br /> • STATE ZIP CO. CITY
<br /> .wk r STATE ZIP CO. PO !{$1;%
<br /> PHONE N0. NO.PRFIIC
<br /> CU TOMSR:EP
<br /> PRODUCT WASTE MANIFEST
<br /> QUANTITY UNITS PRICE
<br /> Q, T1 Tf5" '
<br /> CODE NUMBER
<br /> sed'oil,Non-RCRA Harerdous Lubrl acing CA22I X1 C�- Gal. +- ✓rii� ': •'# '
<br /> Waatc, indusgrlat CA221
<br /> Liquid «,' ,4
<br /> Gal - -'
<br /> lhaLAgroa,o,Gs�1n Non.kCR1 IrawJuyy ' J)thFiSi'I Ct7t}'',)?lz '
<br /> ' d CA 134 Gal.
<br /> a. �`" I"':,LIuld.N,O.a.NA -
<br /> f%ftt Ga(. 't ...r'jl. 'f:+:::
<br /> '0 I'c�-Wdte%1"Tan-RCRA Narardous Wnste Liquid CA223 Gal.
<br /> i�Y6n` ou ater -
<br /> Gal. r,,i 413
<br /> Wastrr,$alids and Sludges
<br /> Wash Out Gal' ;t
<br /> t.�ks: ;`t�r4�r t1ttjr
<br /> Each
<br /> Pressure Washer/Stearn aeancr 4.
<br /> Day14.
<br /> ,,}► «1 k �':�;
<br /> •C 'SIItC p 6 f'tr9. _p�k4l�• �'•"lt< 1 �,,s )e
<br /> 5peciry Product
<br /> (3IPe&Tujrje6hcJSpecIfyProduct
<br /> h4001 ' pPtn ❑Clor D Tech I000 Ftdl
<br /> <Pasc
<br /> ❑
<br /> Retains sample# — _--_ r •� ;1: .F•
<br /> nixed `ft �
<br /> i a�.
<br /> ,I4,3eryka Work Dwrrl tion: '— ( a' ruL�F'r:tl ',•`
<br /> Nati*tsuSl `['> Ft ;
<br /> Other
<br /> , r" �•r, , „�;.,STK`' '', .t
<br /> TS Consolidate Manifest DRIVER C TT�, ��" +?�n� �0i''''
<br /> tim
<br /> an all,Inc. (� E"�V=011.I .-Davb❑ Evergreen Oil,Inc.-Fresno ❑ linfe Irt^_11"It:Out
<br /> 1168805tnidtAve. LJ Road 30B 4139 N.Valentine "`7!i10 to 1
<br /> r�Ncwark,.Cpp 94560 Davis,CA 95616 F=resno,CA 93722 Q Tunk/Drum 1'ruperly Labeler! F 'h
<br /> CAD9808$7418 CAD982446874 CAD98244688r +[S�`r"iI.Gt�Ir�Irf 1211'
<br /> ❑ Aceumulurion Slurt I)ulc MarGul
<br /> ❑ Sve men Env.Svc. $ L4f;w w xw
<br /> �0r�- ❑ vapoarOT lrc Sraualvt¢Ett 1 Q Nnu�v K"�ping- fsnkl[7rum Clru„ ,r
<br /> 16bo 11 San 7 Sana Wast B ttcmvia U ❑ Uthar<<rvircn c•heckral: O oil, O Piltew/Drums A,�Et4c
<br /> rrs0ahori tcYA 907 :soca Matifl A 93454 `i•4
<br /> 1CADR1.6964 CAD982446$ $ ❑ Called in utlwr services needed 011F`11;0
<br /> Source: Collection Station
<br /> Goncmtar ccttifres that it I)us estahll®hada pro
<br /> ❑Gavemment pvq •'' ';_,X
<br /> yuantity fit toxicity of the hrutardous wa&te to the
<br /> n ,�S
<br /> Q Marine (] rYcult�ral 0 Industdal gcnarutor to be cconomically pructicablo,side GUMS
<br /> .and havel'
<br /> form
<br /> IMPORTAN� NOTICE REGARDING THE DISPOSITION OF YOUR OIL, '
<br /> Per Californla Health and Safety Code Section 25250.9,Evergreen hereby advises customer that customer's shipment of use
<br /> p �ell-•tnay:>�e• ;
<br /> transported to a facility Char is required to comply with federal regulations applicable to management of used oil,but that is not toq'41 ed'tii;,"i
<br /> comply with the more stringent requirementa I applicable to hazardous waste Management fuciIitics.California foci lides that ha 1';
<br /> � . P �Cda; Cd' • :•:
<br /> oil are required to meat those more stringent requirements.and some out-of-state ttcttitics that process used oil also meet thosai guIr mon
<br /> Th734 include more stringgent leak detection geld prevention requirernent5,engineering certifications of'tflflk 111(0 at ,Fula flnan ! ,
<br /> cf sure and accidental refeasm it is lawful to send used oil to out-of-state facilities that comply only with federal used oil mana"e h
<br /> anti nbt 1,heaa more stringent r quirements.This notification is for Information purposes on4y..•
<br /> D er 5lgneturo
<br /> Al
<br /> Print Nim-a Route# Date Generator's Signature
<br />
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