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FREN- 10UNNE ENVIRONMENTAL SJORVICES9 INC. <br /> -nd PaN mcni ftl: Phone: S190-559-43 EPAID CAROOO 171017 <br /> P.O. B.-o' Phone: -0-419-3'00 US.D.0.1:4 1484667 1,W010E # 1 •7 <br /> X ACLI%Hit.Ca. 94696-2s-4 Fax: D.T.S.C.0i 3544 <br /> %vxx-xv.hanva-stererr oval-coin CA#274461 Date <br /> SITE ADDRESS BILLING/MAILING ADDRESS <br /> Customer '=n Custonier <br /> 4 r <br /> j; <br /> E.P.A. 4 Phone <br /> Additional Contacts: <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> I WASTE QUANTITY UNI <br /> 30 45 • 60 90 365 �c CODE <br /> 7 .80 MANIFEST NUMBER TS PRICE AMOUNT <br /> - cve = A' A2 5g ZI Og 0 5g El 30g L3 55g 13 S P F <br /> 1C-ec' <:-: 7e-z- Z) ss ZJ z:a 11' J gene afar Knowledge 0 PPM <br /> 7 <br /> rcr)sr,o-ct!o- C�-o,ges,!Acdifc-c'-rvc i-ne/Additlonal Labor/LAB Packing/Site Cleaning <br /> Clear: Y N Labels 7 A/F LIOF Oily Debriss <br /> SERVICES REQUESTED B <br /> I TAX ' <br /> We <br /> 4cce"I = P. O.# TOTAL CHARGES: <br /> GENERATOR'S CERTIFICATION: zec ore--u---e=17e'175 0"Irl.iS consignment are fully and occurclely described above by proper shipping name and are classified,packed,marked,and <br /> .obeie-.,arc ore c;!,es-.ec'f . oy­gnwcy cccording to coplicable state and national government regulations. if I am a large quantity generator,I certify that I <br /> have C PIC2,c-in C*Z=e :: '-C _—e zx!z'­.of generwed:'--4he legree!`ave deTermined to be economically practicable and thotl hove selected the practicable method <br /> 0,'rea' err s'crc;a C-::scc-c =-,n -c—e ch n•nli­ized tKe oresent,one!,_-ture threat to human health and the environment;OR.if I am a small quantity generator,I hove made <br /> _000c 4=:1 e"cr. Mc' <br /> x­= e -e �--_,c;erren*metras thict;s available to me and that I can afford. All used oil from the generator listed above-ill -le� . ; <br /> be!rarsco-tec Z Z !cte z'Coi-foln*c:to P.rocuce used oii into recycled oil OR a facility that is required to comply with Federal regulations applicable to the <br /> -luspected hazards associatedif+h lhiswa;te has been disclosed. The customer agrees to pay reasonable costs and attorney <br /> e"C.,c:;.posps c!this obligo'ion shall be in Solana county. I declare under penalty of periury that th 54awoinq is true and correct. <br /> DISPOSAL/RECYCLING FACILITY: colf4cition station Industrial Agricutture Govemment Mariner["pCher Industrial Lubricating <br /> Oil oil <br /> Wd. <br /> Pint mprilite —Generator's Signature <br /> 736veki Signattire <br /> Stott Law Requires that you keep this Recelpt/Bill of Lading on file no less thorn 3 years. <br /> ZTT/LVO[8 ON1 SOAS ANH AdONHHA 66VCSVVLOLT YVA TT:VT TTOZ/ZZ/90 <br />