Laserfiche WebLink
1010812010 10:18 <br />0 <br />fAX) P.0421045 <br />WORK ORDAERVICE AGREMENT <br />4, Evergreen Environmental Services <br />:14 dedicated to the protection of the environment <br />To Schedule a pickup, call <br />Send payment to; <br />800-596-9455 <br />Eveween Oil, Inc. <br />6990 Smith Ave., Newark. CA EPA# CAr*82413262 <br />Dept. LA 23234 <br />I65Q S. Son Pedro SL. Carson, CA SP" CAD9924X3262 <br />Pasadena, CA 91185-3214 <br />ZMEM <br />Sales Order # <br />PRODUCT <br />WAM ALMEMST <br />CODE NUMER <br />quANTiT iTy uNrrS MCC AMOUNT <br />Used oil, Nan-RCRA Hazardous Lubricating <br />Waft, Liquid InduptTial <br />CA221 <br />Gall <br />GAL <br />UPA AvwmWv*AwMw=. No+rcitA F -woo. <br />Wwkb- - Wd <br />CA134 <br />Gal. <br />RQ Wow qmfto Lupga. MOAL NA <br />e, wow= Mth 1121100"I <br />Gal. <br />Oil & Water, Non-RCRA Hazardous Waste Liquid <br />CA223 <br />Gal. <br />Non Hazardous Water <br />Gal. <br />Waste Solids and SI -19" <br />Gal, <br />Wash Out <br />Each <br />Pressure Washer/Sicam Cicaner <br />DAY <br />Transportation <br />Fuel Surchaige <br />_KM. <br />% <br />GlycolBulk 450PUpecify Product <br />CSL <br />Glycol B1114oncispecify Fuglict <br />Gal, <br />TM. eClar D Tcch 400ZA�m' 0CIQrVTecbloW --Mpus <br />Fail <br />Retain sainple # <br />quired 2-3 <br />.Field Service_ Work Description: <br />Other: <br />Otbw. <br />Total Charges <br />TS961F ?I Consolidated Manifest DRIVER CHECKLIST <br />Evergreen Olt, Lea ❑ 0' 4EVerm 1, Inc. - Frasno D rime InTimeOut <br />66� Smith 13 N. Valentino <br />A I ndj <br />30DOIL Ine. -Davis[: to <br />Newark CA 94560 Davis. CA 95616 Mgo,=722 0 Tank[Drum Properly Labeled <br />CAD980897418 CAD992446874 2 C3 Accumulation Stan Date MarkLd <br />E 3 , S <br />TTV. S C Susilibliao C3 House Keeping - Tanki6rurn Claun <br />. P <br />166 S. San 1:11 717475AMM 3. encravi a C3 Othcr Service.,; Checked: 0 Oil, M Pilter-ji0rums, C3 Aji[ifrec7c <br />Carson, CA 6 Santa Maria, CA 93454 <br />CAD98169 CAD9821446858 U Culled in other services needed [3 Oil, -0 FlItcrs/Drdins, Ll Antifrcc7c <br />Generator COMMOS that It lids established a proMsto I t( . rueduce the volume of <br />Source: Collection Station U Govemmnt quantity & toxicity of the hazardous w0te to the7desm determined by <br />C) Marine 0 Agficultural Q Industrial generator to be economically practicable. <br />Lhmby cerfity <br />bind the RhOM2 110dgumim to the 1&-rme =Ae reverse <br />side QL 99L&m. <br />IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR OIL. <br />Per Can a Health and Safety Code Section 25250.9, Evergreen hereby advises customer that customer's shipritent of used oil may be <br />tralispo to a facility that is required to comply with federal regulations applicable to management of used oil, but that is not required to <br />comply the more stringent requirements applicable to hazardous waste management facilities. Califomia facilities that handle or process used <br />oil :ajee ired to meet those more stringent requirements, and some out-of-state facilities that process used oil also meet those requirements, <br />n more stdrigent leak detection and prevention requirements, engineering certifications of tank integrity, . and financial assurances for <br />c <br />os <br />st <br />u <br />ur <br />I an <br />r accidental releases, It' is I to send used oil to out-of-state facilities that! coqwl�,, . only federal used oil management standards <br />and no th e more stringent require This notification is for information purposesZY <br />70W_.A_� 494M 44 - -LID �Ya <br />Driver f irature Print Name Route # Date �Wza&-s Wature PrinitNa e Date <br />tt. ^--. A-1- <br />