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1010812010 10:05 fA3) <br />Am <br />441 9 W <br />Evergreen Environmental Services <br />Containerised Services <br />dedicated to the protection of the enviromnou <br />To schedule a pickup, call Send payment to: <br />800-596-9455 Evergreen Oil, Inc. <br />6880 Smith Avo., Nowark, CA EPA# CAD982413262 P.O. BOX 30517 <br />le54o S. San Pedro St., Carson, CA EPA# CA098241.11262 Los Angeles, CA 90030-0517 <br />GENERATOR/10111 LOCATION --A, - -RI MING INFORMATION <br />P.0171045 <br />mk]�M <br />Sales Order # <br />. <br />Date: '—f�z — <br />PRODUCT <br />WASTE MAN UST QUANTITY UNITS <br />CODE NUMBER <br />PRICE AMOUNT <br />Waste Utex Paint (Non-RCRA) <br />AP A& <br />Waste Latex Paint (Non-RCRA) <br />Waste Paint Related (Plarrunablea oil based) <br />Waste Paint Related (MarnmAblc4 oil based) <br />PRODUCT <br />WASTE MAN UST QUANTITY UNITS <br />CODE NUMBER <br />PRICE AMOUNT <br />Waste Utex Paint (Non-RCRA) <br />Waste Latex Paint (Non-RCRA) <br />Waste Paint Related (Plarrunablea oil based) <br />Waste Paint Related (MarnmAblc4 oil based) <br />Waste Aerosols Cons <br />NaVL-RCRA RAMadmM <br />Afilall MAVIEW =-d <br />Moa-jRCRAV&2nWfdWAW0h',s*W H, <br />MWWQ��� <br />Waste Corrosive 11cluids, n.o,& <br />Waste Mmmable Li aids, n,o.s, <br />Waste Plamn;ablcLiquids, _n,o.s, <br />Non-P,CRA Hazardous Waste, Liquid <br />Non-RCRA 1-14zardou! Wasta L!2uid <br />Waste Toxic S�Suids or Solids (Clam 9) <br />Waste Oxidizing LiSulds or Solids <br />Drained Used Oil Filters <br />ErnEty Drums <br />Non flazantlous Water <br />Non HaLardoua Water <br />Non Hazardous Solids <br />Non Hazardous Solids <br />, 2lLcal Bulk 50/5D <br />cal Bulk Com. <br />TSDF <br />Inc.Aveiverp" F_Fit <br />M '6880 Smith 33210 Western <br />L <br />Newark, CA 9456�bUnlon City, CA <br />CAD9W887418 CALO=91507 <br />F <br />94587 <br />TOTAL CHARGES <br />/Q57 <br />I <br />01 <br />Generator certifies that It has established a program to reduce the volume or <br />Source: 0 Collection Station E) Government quantity & toxicity of the hazardous wasto to the dogma dotmained by <br />❑ Marine Q &r cultural Ej Industrial generator to be economically practicable. <br />._by, cartirl that I have read and have the authority to <br />bind the above tastedP-enerator to the terms on the reverse <br />Retain sample # side of this form. <br />IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR 011L. <br />Per California Health and Safety Code Section 2 e by e customer I h' nt of used oil may be <br />a is sou that <br />c 0 e"' shipment 'Ptne <br />�applicable <br />a 0 "na 9 0 used <br />Oil but that <br />adv <br />'tom customer's <br />e "a p"'c bl to management <br />in n, Of u d <br />m 2 m 1, <br />Evergreen n'Iti s. C 1 facilities <br />0 <br />transported to a facility that is required to comply ' vi"' federal <br />r g 'tiothat is not required to <br />comply with the more stringent requirements applic b oil hazardous n a s that handle or process used <br />management <br />ea facilities. <br />'a �l cals, e th <br />4 1 t 02a 6 wft3te a i f ifom f <br />oil are required to meet those more stringcnt requirements, d soma <br />f_snsw facilities that process used I meet those requirements, <br />v tion M a out -0 0 <br />These include more stringent leak detection and prevention <br />re anrequirements, e ineer! ce i to tio of tank i arity' and financial assurancca for <br />no "'i certifications <br />na integrity, <br />closure and accidental releases. It is lawful to send used oil to out -of <br />state <br />to facilities <br />that comply only with f oral used oil management standards <br />notification <br />and not these more stringent requirements, This n Ication isfor i ftio only. <br />Pnliroa .4 <br />'Zi, V'i " 7TT <br />T)nr,ivp. Tunnhirp. Print NAMP <br />