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12/16/03 1'7:25 NORTPAX FRENCH CAMP 2094683433 N0.214 D26 <br /> I �l <br /> , '. GREENLEAF ENVIRONMENTAL SERVICEIJ BILL OF LADING # HT11003 <br /> P.O. BOX 765 TEPA NUMBER CAL000163781 <br /> •LODI, CA. 95241-1765 <br /> ` (209 754--4600 <br /> [Dn7E <br /> PICK-UP SHIP TO:LECITY <br /> ixIIminmminlLLA! RnUSUp;mIAN.. Jm[@1®'n=In.tCA1L!®`.,y1N6!YSx®n�lgq ` 1 <br /> I <br /> tlA�E� <br /> �1 1'CUST NO. <br /> NORTRAX WEST �GREENLEAF ENV. SERV T�03-409 <br /> ADDRESS ( TERMS <br /> DORADA'STREET 3474 TOYON CIRCLESS55 S- El. STATE ZIP VALLEY SPRINGS, CA �PMONE (209)FRENCH CAMP CA 95231 95252 `985--8122 IontlnWtlm6tlmxmfniNxw'm,mm�mllt�11pm111Nmr�+nntlnlamnMlnnlAWlntlIIIIItlIAIAmIA111R11UFllflRrytlllllntunlnl!!rflllhx1111AI kINllNmntlllaWIAIP✓JIIAInINIlNI111N1!II!I}INIVfxllgNllxnlAlIIIDIYVIVINmAIVlntamlLlyII111AAupuIllNWmm]C41ULin'.IV.UJQ'mm�!1mmmItRJINNIY 1 1 <br /> I <br /> r CUSTOMERS PO# <br /> u IIQLfppl➢f6119�919&�111II411g81IG�1110�f1pI�RIIIN161RIRIf1mNINIGflflOIHIND191�mfl1flIIIflIp81RINININflmININIflII��NIRIIiIflINl1!ItH11�141sIfd0lNlflllin�,ININI�I11111NIiNII11NINf81!4+,11191'aulNlftlII�NgIfHN11Nl1mb'1llgllll!IIIIII!VNIiOI���NNN>NNf@NnNfliIIGR�N!N�iINI�NNPIpRf�l <br /> PRODUCT <br /> PRICE I AMOUNT <br /> CYlif!mltOteMl!11CriNPoCIHPo'uMIM'aAfAtlmalmn!m mxl6n:C!'JI�Ir l41m'i14nIIIIIAAIICInnIi4nIl111ImfI.IInIAIAIRmxUllwxmallnitll'iIQISn�imnPllnlp(IIInIi111A111xllllllnmll'I IIIiItlINNItlIS11SAAllI!WI VVII,T,RSII1m II�hUfllw U+mmA!nnn;lnn(Pnt:l!®I GIL'4R'a'IDfl4'�NW'3ID'�.9'Jlfi'1/lat�:� <br /> DRAINED USED 0 L FILTERS 55 GL DR 55.00 <br /> ' mru!Ima!s!alma!emmNNlml!!IDwmpRnimufpf;minMA molal!NunumlunnmawmlmNmmuuxnwrmmmnminxomnnlNWlgl�nul umwmmerottclnlromuat un!nn luwluaw!nrinlulmauumnitimuulun nlamlmammen,ucnleml:�xl!pa!�I elammisatamvall,,;mloTt+'applrmml % <br /> OIL ABS6RBENT ATERIAL 55 GL DR I! 140.00 <br /> Io811ntlBNNIm1n79kYtl1BMIlxeflllnMMmmIIIIAINn Slmillmmimm�ammnnlnn!pllnumnllUWnminrQlnmuuuxingAlGllpmiwl imm.m.... Alrtnn lnniwpllulnn WmuunmmAUAnminlmm!NNAM6lm lmrtx7lAAWminlpicluwnenlml Nn!111um�mnmlmnlnlmlmplpnintlEm:nlx <br /> � ulum[FP-1 <br /> tnm�rlmon!numovllmmaralroeawrx!slnr Iellmollxwr.ielnY;Ilullnmml:numalleNlmnAlWnnxmaunxlrwuemlylul,{ m�xl4:eu.untr.!IAnuua{tarn!w�,xunlWulnmlrmnvnlmnnuulwummn wtmn!nnmlmuaretnlclmu!xmn`�mlulnlpincoRlunu•,Imtlmulnm�tnnr�rn I� <br /> SC EMPTY DRU SCRAP METAL ` 1 <br /> SC EMPTY DRU PLASTIC I <br /> ! mW Non Iw4roluAWM"m)IN%r mIN!1!!® nwnm$ImmlUlnnlnllluxW10n1nIUnUnfxlmpiAilluulrm!nNluaml111Vlsl 6N}IGIRIIIIfIIAIASnmMIWxnlnlAlY IunlNllAiquknnumxmlmimm�!mmn11'VdI�A1n+nNUfumlleMummlO!c I�IL71R�®Aa1DP77nYmamPodl� <br /> I <br /> ( DROP CUST DRUM NEW ACCOUNT. <br /> mnmmWxl4lmIDar4mlalmnlm IWxpunnupfnWmlm minlrmm�muuunnl4luml lamonnnnnu;pli!nulmnluullmmmnnpnl^lYl.�Iymmnulxnmm�lmplNmpinualA Innneunnnmuaml4mmnm!mlac!ww fanlWoirwul�+Rlwrvincmnruu mmruufAlnWlmx!�ImYmt�rtmr�erm! <br /> CRU5HED I� UNC SWED EMPTY I ff <br /> ,mnlatarlmNtnlmm!Af4Yxre elmmm�llnnmlalwan Ilunlmm�unnmauluinxn+loll!mmnu!rn!mn'ul!TlYrlllu�wmintmlan+nl�,lu:ImlanullnlnlAlamlxnunratl! .tnnmwmnnuunlnlnnnwlPmr>n!ma`+xmlxmaw!xnm+ro!!m!!mmra,�lhA!pal,o,,u�x.-x+ma <br /> I I <br /> mnnAFRm>timW4NmppinWal� ItlmmmxWm!nRm!am I4NWIn11WHiltln11mn11 IIIRIal7111;IInImWI111mnIRmnIISIN1Al".aimlllrAll ANIn{IfnIIARlpinlYlmrtxllpmlml➢�nlnxmltl11x111antml4lnlylallnlmmllyl illnnmmllpnNn"�n%Im171!!.T.i'.I" L"!47111!101am'Imfnn,Y!!ItlIU141r11'—:14'3ntl� <br /> 19N99lN1011911N91NUN!91N9Nflfl INN91111�f19N1kIPoN19191111i11NIk1111911P111111fl NININIE!19NR11�1181fl11iIflPAIl111N1�61C16uIINNiflll9fllfll9l>m311aliplNliIIN11919►fllll7H�ImDlifl9lN191111111911iIR181P1911UG191RIC�fi19f111U161iNF1+11pI91EiINCfI!991919ffdl!'!C!�VU�IIRIR'r1i�I>r.NIN'9��1�11�1.� <br /> TOTAL a ?1 <br /> I CHARGES > i! <br /> I CERTIFY THAT THE INFORMATION AND THE AMOUNTS SHOWN ABOVE ARE TRUE AND <br /> ` CORRECT. ND THAT THE USED OIL FILTERS PROVIDED TO GREENLEAF ENVIRO SERV <br /> MEET-5 THE DEFINITION OF USED OIL FILTERS PURSUANT TO CALIFORNIA HEALTH <br /> AND SAFETY CODE SECTION 25250.1, UNLESS OTHERWISE NOTED. THIS FURTHER <br /> SERVES ASNOTIFICATIONTHAT THE ABOVE WASTE IS BANNED FROM LAND DISPOSAL <br /> PERSUANT to SECTION 66268.71(10) OF TITLE 22. I ALSO ACKNOWLEDGE THAT I <br /> HAVE READ AND AGREE TO THE TERMS AND CONTITTONS SET FORTH ON THIS FORM. <br /> 11 4m1ng11 ImmlAml!mUnrintl4Y4lYI If4YHIAInAM1111L:n1 n161 'AVpn Imwlonmlxunnnulrnnmalpnlmllr� IAIYWIRIa(nnN9imnIAIRRi7mpn!min 11;IIIIVmnIAIInIAnl AInUAIpIAIYIpAIIIVIURI«II IUILAYIIUU@f{aintl11a4frdl <br /> �, DRIVER SIGNATURE DATE GENERATOR'S SIGNATURE DATE <br />