Laserfiche WebLink
2011-Feb-11 02:10 PM DSW AG 209-339-336? 0/4 2 <br /> A'A WORK ORDL.JSERVICE AGREEMENT <br /> Evergreen Environmental Services:44, No <br /> r/r'r/il'N/ry/rN the/rr•eller'I/nrr eu/'the rar•Ir'd11AlPrl/ 482473 <br /> To schodulp a pickup, call st-toll pat tllutll to; <br /> 800-5.196-9455 sail Order # r�3SU� <br /> Evt:grecn Oil, inc. <br /> 6880 Smith Ave„ Newark.GA EPA#CAQ9624132e2 P.O. BOX 30517 <br /> 18640 S.Ben Pedro St.,Carson,C! EPArr CAU902413282 Ln, Angeles, CA 90030-0517 <br /> GENERATOR/10BLOCATION 13111A ING INFORMATION Date:% 'B <br /> tiIC I , } � l NAN{E <br /> J(w CASH r C: CHECK <br /> ADDRi S /D AbDRESS CUS,�()hIt COU <br /> 1, (� C NO. <br /> C TY SA'; ZIP Co. CITY STATIC ZIP CU, PO# 06.14s� <br /> i a L� <br /> PHONE NO, PHONE.NO, PItUFILF NO, <br /> CUSTOMER EPA II)NO. <br /> 3 �Z97 1 1 NO <br /> PRODUCP WASTE V[ANIFE.ST QUANTITY UNITS PRICF. AMOUNT <br /> CODE. NUMBER <br /> Usad oil.Nun-RCRA 1-hazardous Luhricatiag CA22 77j-/ j Gal. <br /> Ogg:: <br /> iquid Industrial CA221 Gal. <br /> itivr ANR-1.Noo-M-11A Ilumfti-n CA 1 i«1. Gal• <br /> .�„hu.un4 a.uyiJ,N!r,ti.nnCA'21auumnk tlM hnL� IRYII/�;xl2 Gal, <br /> ater,Nun-RCRA liazardous W:Ixtp IJyuid CA2'_1 Gttl.olids uttd Slud'Cs Cl;d. <br /> Wash out Each <br /> Druined Used OH I.,illem Druin <br /> Non-RCRA Hazahluus Waste Solid.,hail'dchrisl CA223 Drum <br /> Empty[)runts Drum <br /> Transportation Hex• <br /> Non Hazardous Will Gul. <br /> Glycol Bulk .0/50 Gill. <br /> Glycol pulk Cunt. Gni. <br /> THST; clor 1)-I cc•h 400(1Z�pprn ❑Clor D Tech 11100 Puss❑Fitil ❑ Halogen Dcleetar/Flame Test Pnss ❑Full <br /> Flekl Servive Work Description: rtila� 11t1rLrt'h <br /> Other. <br /> Uthcr. <br /> Vucuunt Services TianC <br /> Out of Y On siic )IT sitC Orr loud Stan Orr Luud End Rc rn III Yurd <br /> TS Consolidated Manifest <br /> F.vcr'men oil,Inc. EvergaNa F:nv,Svc. Gvcrlirwn Env.Sve. AJS Filter <br /> hHH SmiIII Aw. Rata1.10 11.[9 N, Valentine 15131 Clark Ave, <br /> Ncwurk,CA 94560 Duvrs. r1')561fo hresno,CA 9.1722 industry CA 91745 <br /> (',\I)9HOHti7alx UAD9tc21w M74 CAD9824468H2 CA )974.12 <br /> Kvvrgreen l nv,Sv . Evergrccn tiny.Svc. I—' C'FR n CFR Greenleaf fan',Svc, <br /> 166(14 S.5au PC I 745 A \\{est Better via lJ 9.W K Sluasnn Avc, —t 33210 Wentem 3474 Tuyon Orvic <br /> Cirsun.CA Y h lama,N ria,CA 93454 Los Anggeles.CA 9[x11 I Union City,CA W587 Valle) Sprin66's.CA 9535_ <br /> CAI)9H169 ' (1 CAD9828H5H CA 1,12 110021 CALOW491507 CAL1160 IZI <br /> SOIIfCC: CUiit'Ctl(ln Slilll Il D Government Gcneratur Ccnifres[I'M it has estnhlished a program lit reduce taw vnlumr nr <br /> I quantity 8e loxicity or the hnzurtlous wade la 111Cdegmv detl:nnined by <br /> C) Marine ❑ A rl'iCUitUliti ❑ IndUStrial venerator tet he economically pnicticahle. <br /> 1 hereby cert10 that I have read and hnve the atdhorlty to <br /> Retain sample # �—S. L bind the above listed itionerator to the terns on the reverse <br /> xide nt•this form. <br /> iIVIPOR�ANT NOTIcr Rl?GARDING THE DISPOSITION OF YOUR OIL. <br /> Per Caltforttlu Health and Saretr Cod Sel:[1011 34350.9, Evergreen hCrchy advises customer that c'uslonter's shipntunt nl'asatl oil tray he <br /> trionsporlecl t0 a I'aeilily thus is roduiwd t 1 r0tttply with iidcral I-Cgulatiunx applicable to ntunagetnunl aP used nil, bill 11110 it. 1101 rCyuitrd to <br /> comply with IIID Ilton stringent rcllUll'Cllt'llts uppltcilhle to hazardous%veste Ittuntlyienwnt l wililies. Calltornia facilities tliul handle korpmrCs used <br /> toil an; IeeuirCd !u nice[ those ntnrr noir Ont I-quireirents, arld snrtte out•of*-Stute facilities that process used oil also inner those rrquiremems, <br /> Thane inc�ude mole su•itigew leak dClCkA nt trod prevention requirements, en�rint:erin certifleations of l-Ink integf-ity, <br /> o �' , b Ifl(i I.....ciai assurinces for <br /> cue ore and ucciJetttal releuw . Il is lualttl to ,end used oil to uul of•Stale facilities Ihat e•nmPly only with federal used oil ntanuEcntrnt stand <br /> a d of these marc vtringcnl rr luiltrrtent�. This 1100111cuiion is 1'or information purposes only. <br /> IN <br /> s i� <br />