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10/0812010 10:07 fAX) P.0211045 0 WORK ORD ERIVICE AGREEMENT' Evergreen EnviromzenW Services No - 501562 dedhated to the protection of the environment i To schedule a pickup, call Sated paylment to: Sales Order AnY 10 / 800-596-9455 Evergreen Oil, Inc. tt118® smite AV*., aunt, CA EPA# CAISe241 2 P.O. BOX 30317 �Q 1 W40 $. $en PedrD 8t.. C®real, CA sPAA cA09ea4i 3292 'Los Angeles. CA 90030-0517 Date: CvwwvA,rAR1TAR T AVATTnN HILL lMn INFORMATION NAME w - — --- - - - - NAME CASH CHECK r UNITS PRICEAMOUNT Used oil, Non•RCRA Hazardous Lubricating CA221 ADDRESS ADDRESS CQMER L X NO. 1,0 1�j Gal. CITY STATE ZIP CO. CITY STATE 71P CO. # Gal. e wma nNk Frx►ir n PHONE NO, PHONE NO. Oil & Water, Nnn•RCRA Hazardous W&Qe Liquid PRpFI1.E NO. Ij,4T l�R ej t1) Gal, Walde Solids and S1udg a; Gal. PRODUCT WASTE MANIFEST WASTE NUMBER QUANTITY r UNITS PRICEAMOUNT Used oil, Non•RCRA Hazardous Lubricating CA221 Oal• Induetriai CA221 Gal. t qua.quxi�e Amarnxry�. wal•ataA n CA134 _ t tt..t E. { Gal. e wma nNk Frx►ir n Cal. Oil & Water, Nnn•RCRA Hazardous W&Qe Liquid CA221 Gal, Walde Solids and S1udg a; Gal. Wash Out Each Drains(( Used Oil Filtm Drum Nan-RCRA Hayardou:s Waste Solids (oily debris) CA223 Drum Fanpty Drums Dram Tninxporatiun Hes. Non H'dcudoas Water (sial. Glycol Bulk "/.% Gal. Glycol Bulk Cone. Gal. TEST:[] Clor D Tach 4OW—.ppm ❑ Clur D Tech 6000❑mars ❑ Fell ❑ Halogen Dcta:tor/Flume rent ❑ P:ens ❑ Fail Field Service Work Description: Total Charges Usher_ Other. Vacuum Services Time out of Yard—On Site Off Site Off Lead Sutra Off Load End II I 11111 Rctuni w Yard ❑ Consolidated Manifest Everrmn Oil, Inc. r7 1wergrucn Env Svc, r' j Evergrrxn Env. Svc. ® A]S FilterOK I—I 6880 Smlth Avg. L..I Road 30B 11 4139 N. Valentine 1$131 Clark Ave, El Newark. CA 94360 Davis, CA 95610 Fresno. CA 93723 indwiry CA 41745 CAD91st K?418 CAD982446974 CAD982446882 CADOWN7432 ❑Hoerr�yreen Hnv. Svc. ® kveryreen Fa►v, Svc. M CFR ® CFR ® Gire duat FArv. Svc, him. Sana Pedro 745 A West 5 teraviu 944 E. Slausm Ave. 33210 Wesw•rar ;.674 Tuym Cin le Cancan. CA 90746 Santa Mario. CA 93.494 Lacs A�n�gcles, CA 90011 Union Cit> CA M11 Va)leyy S� nj�i. .. CA 95342 CAD 981696420 CAD982446959 CAitXlt)I)W.I CAME% CALW-14411 Oenenwr scathes tbuu it N,. iA ahli%hed it pnigr m to rgttuce :he voluine tv' St�UrCC: ®C011ectiOn Station ❑ (aOvF,i't1IT3et1) quantity & toxicity of the hureruou,•a wu.w ua the degree deta:rmimil t,y ❑ Marine ❑ Agricultural ❑ Industrial Renernttir to ts: a f<anamtically isve caHla. 1 hereby certify that i 6avo teed and hoot: thB authorlts to bind the above 11strr4 generator to the terms on the reverse Retain sample Al side of this form. . • IMPORTANT NOTICE REGARDING THE DISPOSI'T'ION OF YUGR OIL. Per Calllrornist Health and Safety Qide Section 252.40,9, Evergreen hereby udviws customer that eustomer's shipment of used oil imiv be trunspnrtetl to it facility thin N required to comply with federal regulations uplslicable to manugement of used all. batt that i, not m4uitral to Loins ly With the mom stringant rcquironicnts applicable to huzardouh wime munugcrwrit f.wilitics. Culiforila facilities that handle or prewcss used oil ore�t'�cyyuired to rneet thtvw more astringent requirements, and sonic nut-est-r:tate facilities that praia:c%. U -4d ail also mn meet those requireinctr, 'these: incitide more Ntringgent leak detection and prevention mquirements, engineering certitit:utitnt. of tank illteltrity. and 0nnficlatl asmuntnc4:s for clem re and uccidentid releuses. It it lawful to ,tint! used Gil to out-or—ante feuailities that comply only with Fedend usied oil nutnuttement eta ndurds and not these (noes stringent reyuiremcn%, This notitit:ation is for information puiixntes unl�. V'" `ter/��.� r �� J r� • t+~�� V��+�'. r�_:..... o:._ ..._. n... 1.1_... . V's _..._ is r._._ t•;. n • s1. c. .