Laserfiche WebLink
FREMOUVVEXVIRONMENTAL SbRVICES, INC. <br /> Send Pa%ment to: Phone: 1:0)-559-M EPA ID#CAR000171017 7 Q <br /> P.O. Bot 28-5 Phone: Or-448-37,00 U.S.D.O.T.#1484667 INVOI�C! J # l V <br /> 26 <br /> Vaca ille.Ca 9=696-2875 Fax: 0 -448-3499 D.T.S.C.#3544 Date v r � <br /> w ww.hazw•astererno%-al.com CA#274461 <br /> SITE ADDRESS BILLING/MAILING ADDRESS <br /> Customer Brannon fire Customer Brannon 7 <br /> J905 Clelrernonl .4 an L i F, B ox, 988 <br /> Stockton, CA C9520 / S-ockfo!1. C'A 95201 <br /> E.P.A. # ;L 15..•91 Phone <br /> Additional Contacts: <br /> :i; <br /> PRODUCT - ERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 14 21 30 • 45 60 • 9 • 180 • 365 W C WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> .r' --rpt' - 1.008 <br /> :G -•?,...•��' - - '_ .ids y -'�: _:BcQ'!n@-iJi�Sf3ii �'::JIJ'.•' <br /> Empty Drums Provide ` Remove 1 A 1A2 5g ❑ IOg ❑ 15g ❑ 30g ❑ 55g ❑ S P F <br /> Clor-D-Tett Q4000 Test Kit: Test ❑ oss❑ Fail ❑ Generator Knowledgea– PPM ^J <br /> Transportation Charges/Additional ruck Time/Additional Labor/LAB Packing/Site Cleaning <br /> Clean: Y N Labels Oil A/F , UOFebris Oily.� D A/ f <br /> •� , <br /> SERVICES REQUESTED BY TAX <br /> We P. O.# TOTAL CHARGES: <br /> Accept = 0—:__ I& <br /> GENERATOR'S CERTIFICATION: co <br /> c- s -sig-^e-are'u:rr o^d occorotety cescribed above by proper shipping name and are clossifed•packed,marked,and <br /> cceiec.c-p e•e _ __c's -�p� --------- _ _ c'•acco'c-g'o oeo%ccble s'o:e o^c ,ctioncl government regulations. It I am a large quantity generator.I certify that I <br /> - eo_ze'-'•_ -e_ c- - - - ^m'e'an-c--e cegree'rove deer­^.ed to be economically practicable and that I have selected the practicable method <br /> .. <br /> of•,gat a ,- �_ _ _• _.e _ V��'ezed--e 3•e5en'o^c`ufvre'hrea"c human health and the environment:OR,it I am a small quantity generator,I have made <br /> a�I'e ^.'-V^'"_G_'c^:=ze". :.- e;e-.a•c• - —>ec•-aces:-ns'e-.o�cgemer'.methodvf:a'�=available tome and that icon afford. All used oil from the generator fisted above <br /> - e----ec .--e 5 c'e p'Co"o-ic'e produce used cis in:c recycled oil OR a facility that is required to comply with Federal regulations applicable to the <br /> renege-•.e-•c'aec ci e e:c -'Z• =.---e;:;c'rx cr sa,:soected hczerds essociotec with tn:s waste has been disclosed. The customer agrees to pay reasonable costs and oftorney <br /> `ees ir,crec'r•s_cc ec•or -rs ppl'^ptip-. . Vac a Tor pwpcses of this obago?ion shol:be in Solono count I declare under enol of a'u that the for pin is true and correct... <br /> DISPOSAL/RECYCLING FACILITY: •L-eeW0QAIoV_U2j[,pn Industrial Agriculture Govemment Marine Other Industrial Lu <br /> ' - __ .. .: .. _, ':•i N;:�`i•- .....- - :,t-. - ^:'G31 IL19t vantWyEMI <br /> oil Oil <br /> 217:15 Ne+fonds Dr,Easi <br /> new <br /> `er*ry..it +xs t <br /> \. „ t <br /> Pdrlt-Name <br /> Gene toes nature Drivers Signature <br /> Sta law Requires that you keep this Recelpt/BIII of lading on filkno less than 3 years. <br /> - - - - Tn R -Artie +A nr to nF�4nin nn FPA A_r",ei.....e......,,---+..,-•IT('--,I ono /I. -. <br /> ZTT/tf10In OKI SOAS ANH MROAHHH 60£13t'VLOLT XVH OT:VT TTOZ/ZZ/80 <br />