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PRODUCT <br />DRAINED USED OIL FILTERS 55 GL DR <br />OIL ABSORBENT MATERIAL 55 GL DR <br />FP -1 <br />MISC EMPTY DRUM SCRAP METAL <br />iMISC EMPTY DRUM PLASTIC <br />!DROP CUST DRUMS NEW ACCOUNT <br />Ic!!i I !�R- �:Li ; -Sli ! H�l i I E- i I Dl! UNCRUSHED EMPTY <br />7 <br />BILL OF LADING # HT11.005 <br />EPA NUMBER CAL000163781 <br />SHIP TO: � DATE <br />!!ICUST NO. <br />Il <br />GREENLEAF ENV. SERV 0l,08-026 <br />$TERMS <br />3474 TOYON CIRCLE <br />VALLEY SPRINGS, CA @PHONE (209) <br />9.5252 1119.52-8473 <br />CUSTOMERS PO# <br />PRICE <br />offmUMEN"Li Kiii: <br />45.00 <br />TOTAL <br />CHARGES <br />AMOUNT <br />I CERTIFY THAT THE INFORMATION AND THE AMOUNTS SHOWN ABOVE ARE TRUE AND <br />CORRECT,, AND THAT THE USED OIL. FILTERS PROVIDED TO GREENLEAF ENVIRO SERV <br />MEETS THE DEFINITION OF USED OIL FILTERS PURSUANT TO CALIFORNIA HEALTH <br />AND SAFETY CODE SECTION 25250-1, UNLESS OTHERWISE NOTED- THIS FURTHER <br />SERVES AS NOTIFICATION THAT THE ABOVE WASTE IS BANNED FROM LAND DISPOSAL <br />PERSUANT TO SECTION 66268.7(10) OF TITLE 22. 1 ALSO ACKNOWLEDGE THAT I <br />HAVE READ AND AGREE TO THE TERMS AND CONTITIONS SET FORTH ON THIS FORM - <br />DRIVERS SIGNATURE DATE <br />GENERATOR'S SIGNATURE DATE <br />GREENLEAF ENVIRONMENTAL <br />SERVICE <br />P.O. BOX 1765 <br />LODI, CA. 95241-1765 <br />(209) 754-4600 <br />PICK --UP <br />C <br />flNAME <br />U <br />TBRANNON TIRES <br />T <br />';ADDRESS <br />0 <br />1113554 HAMMER LANE <br />M <br />E <br />,CITY STATE <br />ZIP <br />R <br />CA <br />95201 <br />PRODUCT <br />DRAINED USED OIL FILTERS 55 GL DR <br />OIL ABSORBENT MATERIAL 55 GL DR <br />FP -1 <br />MISC EMPTY DRUM SCRAP METAL <br />iMISC EMPTY DRUM PLASTIC <br />!DROP CUST DRUMS NEW ACCOUNT <br />Ic!!i I !�R- �:Li ; -Sli ! H�l i I E- i I Dl! UNCRUSHED EMPTY <br />7 <br />BILL OF LADING # HT11.005 <br />EPA NUMBER CAL000163781 <br />SHIP TO: � DATE <br />!!ICUST NO. <br />Il <br />GREENLEAF ENV. SERV 0l,08-026 <br />$TERMS <br />3474 TOYON CIRCLE <br />VALLEY SPRINGS, CA @PHONE (209) <br />9.5252 1119.52-8473 <br />CUSTOMERS PO# <br />PRICE <br />offmUMEN"Li Kiii: <br />45.00 <br />TOTAL <br />CHARGES <br />AMOUNT <br />I CERTIFY THAT THE INFORMATION AND THE AMOUNTS SHOWN ABOVE ARE TRUE AND <br />CORRECT,, AND THAT THE USED OIL. FILTERS PROVIDED TO GREENLEAF ENVIRO SERV <br />MEETS THE DEFINITION OF USED OIL FILTERS PURSUANT TO CALIFORNIA HEALTH <br />AND SAFETY CODE SECTION 25250-1, UNLESS OTHERWISE NOTED- THIS FURTHER <br />SERVES AS NOTIFICATION THAT THE ABOVE WASTE IS BANNED FROM LAND DISPOSAL <br />PERSUANT TO SECTION 66268.7(10) OF TITLE 22. 1 ALSO ACKNOWLEDGE THAT I <br />HAVE READ AND AGREE TO THE TERMS AND CONTITIONS SET FORTH ON THIS FORM - <br />DRIVERS SIGNATURE DATE <br />GENERATOR'S SIGNATURE DATE <br />