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1010812010 10:02 fAX) P.0121045 <br />.dft Amok <br />1p WORK ORD&SERVIECE AGREEMENT <br />44 Evergreen Environmental Services N2 474087 <br />dediverted to the proteetiem of the rnvimowrenr <br />To schedule a pickup, call Send pay to: <br />Sates Order # <br />800-596-9455 Sven oil, Inc. <br />66130 Sm3n Ave., News*, CA EPAe CAD982413M P.O. BOX 30517 r r <br />16540 9, San Pedro 51., Carton, CA EPA* CAD®92413202 L,cM Angeles, CA 90030-0517 DaW <br />PAODUL" T <br />WASTE <br />CODE <br />MANDIM QUANTITY UNITS PRICE AMOUNT <br />NUMBER <br />Lixed oil, Nan-RCRA Hazardous Lubrv--sling <br />Waste. Liquid Industrial <br />C:A22 <br />C:A221 <br />Gilt. <br />Gal. <br />Wawa Aut+anonw amuMam, V,e,.UrYrp ruuauO., <br />CA134 <br />Gal. <br />t:waru®c+mi«+aanu9aa.=a <br />Ail & Water, NrnnRCRA Hitynrdoue Waste Liquid <br />Rc i99t <br />CA221 <br />GNI. <br />Gal, <br />Waste Solids and sludge. <br />Gal. <br />Wash Ont <br />Each <br />!)ttined Used Oil Filtete <br />_... Drum <br />`don-RCRA Haaatdous W'2me Solids (oily detwis)' <br />CA22-a <br />Drum <br />Empty Drums <br />Drum <br />Truospttrtution <br />Naar H wmdous Wutor <br />Hm*. <br />ani. <br />,Glycol Bulk Z XY50 <br />Gid. <br />Cilyeol Hu Cone, <br />Gal, <br />MSTM Clor D Toch 4ik ppm Ckrr <br />Tech I(Xx) E <br />ffpwo d Fall 0 }iologen DewtLWMame Test Pura ❑ %et1 <br />Field Scrvl`ti Work Description! <br />Total Char es <br />Other: <br />Other; <br />i'iLLuunr Services 7late <br />t}ut of and on Site Olt' Sita <br />.. <br />011 t.aue! Stan OIT Lund find Rount to Yu . <br />TS �' <br />^- <br />(_ Consolidated <br />Manifest <br />Fverttcen Oil, inc. <br />bKttb Smuh Ave. <br />Newark. CA 9450U <br />CA09Wh87419 <br />(— 6Vcrgnea tov. SY •, <br />t� Rrwd _013 <br />Do%i%. CA 93x16 <br />C'AP"2446104 <br />Avcrgreon Hnv. Svc. <br />4199 N. Valentine <br />Fmsiw. CA 0722 <br />C.409,82446292CAI�(Hx)t)97432 <br />M AJS Filter <br />1_,.J 15131 Cluck Ave <br />indust�rYy� CA 9174S <br />M <br />Eivel2l~`Cn Env. S ® Evergreen Env. Sv � CFR r' CFR n tirdenkitl'P-ny. Svc. <br />16 S. Sun 7dq A W01 Rett' 'vire 444 E. Sluuson Ave, s____� 33210 We:srern L—J 54?4 Toyun Cimle <br />CNrrnn, CA 9 46 SHrita Maria. CA 9 53 I.trr. Ans�cclos, CA Rtx)I I Urikin Cit CA 945x; Yu1MY S)�trin `. CA 95352 <br />I�C'AD9gl6. I C.417ii1i?446954 CAUO)i10021 C'A1100915t1-t CALiRR)_I1 11 <br />Source: C' CUtitwCC110t1 SitttlUn tiorxnttttr cenifst, Mill sr fits cstuhlrshcd a pri+grana W redue.`c rite volume or <br />I] (iBV�Pt11t14'>7t quantliy & u+xie it} al'thc haltnlc+ut waW t+t rite agree determined itv <br />i Marine Q AgriCultural Agriculturala Industrial gdaaittw.io he econm vic411) practicuhic. <br />-" I hereby certw that i have read and have the authority to <br />bind the above ilRted-Renerator to the terms on the reveme <br />Retain sample # Ade of this form. <br />iMPORTANT NOTICE REGARDINC THE Dt4SPOSITION OF YOUR 011 - <br />Per Califurnla Health and Safety Code Sediom 252$0,9. Evergreen hereby advises customer thio eusmnier'a shipment of used oil rnuy be <br />transported to u fatality that is requimd to comp with federal regulations applicable to munu#.Ilict►t ai' uwd nit, hul that ix not required ru <br />Comply with the inure stringent requirements up lieablc in hazurdoue wast0 manugenienl fucililles. C'uliftrrnita J11110 itici+ thtu hundle or ptne:exs uSccl <br />tail see rcyuimd to inset those auatti m itoy ngent irement.. and coine out -of ,date faciditiek that process used oil rd.Au ntcel thime it-quie4 tints. <br />Th rncltrdr more shingeni lank dsstaxtion and revendon requirements- enginoaring certltleotiirn. of lank integrity. ,aid finuticiia) tu4rttrcMV0x ft)r <br />V1 t i and accidental nteu,ev. h is lawful to W d u%ed aril to out -of -sate fuciliti" that comply only with federal used all mtutagemcnl itttndwxis <br />an >t these more stringent requirement,. This 4otification is fc)r informa(ion purposes only, <br />