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1010812010 10:18 (Pali) P.0431045 <br />J WORK ORDAERVICE AGREEMENT <br />Evergreen Environmental Services <br />®555593 <br />�Ayded1cweal to the protection of the environment <br />To schedule a pickup, call Send payment to: Sales Order # <br />800-596-9455 Evergreen oil, Inc. <br />6880 Smith Ave., Newark, CA EP" CADOS 13262 Dept° LA 23234 <br />16540 S. San Pedro SL, CM*:1, CA EPA# CAD992413262 Pasadena, CA 91185-3234 Date: <br />GENERAT®R/70B LOCATION RTIX,T r. TNViARMATTnN <br />PRODUCT <br />CODE MA NUMBERMT <br />QUANTITY UNITS PRICE <br />AMOUNT <br />Used oil, Non-RCRA Idazardow Labricating <br />Cit <br />'I ._Gal. <br />Wasto, Liquid Industrial <br />f <br />Gai. <br />Und Automotive AWfteezr,NO RCRA Houwftw <br />RQ wee ComW+atfUte t.daulQ N.o,S. PIA <br />1 ni o®mmlmdsd w holOL <br />CA134 <br />AC . <br />at. <br />Oil & Water, Non-RCRA Hazardous Waste 1Llquid <br />ti1;11123r y <br />(hd. <br />w <br />Non )ia7.ardous Water <br />... <br />Gal, <br />PRODUCT <br />CODE MA NUMBERMT <br />QUANTITY UNITS PRICE <br />AMOUNT <br />Used oil, Non-RCRA Idazardow Labricating <br />Cit <br />'I ._Gal. <br />Wasto, Liquid Industrial <br />CA221 <br />Gai. <br />Und Automotive AWfteezr,NO RCRA Houwftw <br />RQ wee ComW+atfUte t.daulQ N.o,S. PIA <br />1 ni o®mmlmdsd w holOL <br />CA134 <br />AC . <br />at. <br />Oil & Water, Non-RCRA Hazardous Waste 1Llquid <br />_ <br />CA223 <br />(hd. <br />w <br />Non )ia7.ardous Water <br />... <br />Gal, <br />Waste Solids and Sludges <br />Gal. <br />Wash Out <br />Each <br />Prmsure Washm/Steam Cleaner <br />Day <br />7innsportation <br />Fuel 8=1� <br />96 <br />Glycol Hulk SO/3 peeify Product <br />Gal. <br />Qiyeo1Hulk,/Specify! Product <br />M Gal <br />TEST tlw D Tech 4000. pm <br />❑ Clor D Tech 1000 c6ass, <br />❑Fall. <br />- <br />Retain sample # <br />ReJr+ed <br />Field Service Work Description_: <br />Other. <br />Other. <br />Total Chat° es <br />768 <br />Consolidated Manifest <br />eenOil,BOi1,Lec -Davis 13V Oil. Iac.1?resno80 Smith Ave ❑ Ro 3013 41391v Valentino• <br />N -Werk, CA 94560 Davi CA 95616 Fresno, CA 93722 <br />CAM887418 CA15Si8 *6874 CAD982446882 <br />j-� A F.nV.3Vc. Od,itic•Sawmalls. <br />uu I66 S. San F 7 A Weal Ben®ravia <br />Carson CA 907 Santa Maria, .A 93454 <br />Source: aCollection Station 0 Government <br />El Marine ❑ Agricultural ❑ Industrial <br />Time 1n_ Time Out <br />Q Tank/Drum Properly Labeled <br />Accumulution Start Date Marked <br />House Keeping - ThnIODnem Clean <br />Other Services Checked: ❑ 011. Q -Filters/Drums, 13 Antifree7.e <br />Culled in other services needed ri 011. n Filters/Drums_ n Anti <br />,I <br />Generator certflies that It has established a program to reduce the volume or <br />quantity & toxicity of the hazardous, waste to the dosree determined by <br />generator to be economically practicable. <br />Lk=bj_crxfift that I read anti havg, uthodty to <br />bind the above lison the X0v—R,I,Isg <br />55!115 aY this rortn. <br />IMPORTANT NOTICE REGARDING THE DIS]POSMON OF YOUR OIL. <br />Per CallforMa Health and Safety Code Section 25250.9, EveMmen hereby advises customer that customer's shipment of used oil may be <br />transported 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 with the more stringent requirements applicable to hazardous waste management facilities. California facilities that handle or process used <br />oil are required to meet those more stringent requirements, and some out-of-state facilities that process used oil also meet those requirements. <br />The include more stringent leak detection and prevention requiremet % engineering cerddcatsons of tank integrity, and financial assurances for <br />clo and accidental releases. It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards <br />an t these more stringent uirements, This notification is for information purposes <br />ver Signature 1Print Name Route # Date G erat Signature Print Na Date <br />Whit® - oi.,1, If-- ^_,�-- ^_-.. r._.__.._.... <br />