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Send PaimFREMOUN El IRONTMENTAL SERVICES, INC. <br /> P.O.Bos 28-4 pnone: " '_44F :-fin i .S.D•O.T.= '484667 INVOICE # 27524 <br /> Vaea%ille.Ca 95696-28-5 Fax: D.T.S.C.--'354,1 <br /> w��-\c,];az�tiasterec�o�al.com CA#274461 Date — <br /> SITE AOORESS r. BILLING.MAILING AQPRESS T, <br /> 1i + II ill I 11iCustorner <br /> Oil. 10 <br /> tel.^�. •.vl. ../. - �•V L.l i x.11 9�2�/ 1 <br /> E.P.A. = . _• ', 0 Phone <br /> ii <br /> Additional Contacts: <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 14 21 • 30 • 45 60 • 90 • 180 365 WAC WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> I <br /> Er-o^y Drjr-s ,errove 'A i 'A2 5a Z) 70g J i 5g-J 30g ❑ 55g O S P F <br /> -e_- :3 loss :I Fci? 7 Generator Knowledge PM <br /> ruck 7 -- e Additio^a: <br /> Labor/ LAB Packing/Site Cleaning <br /> Ciecn: �obe!s 71.A;F la <br /> UOF Oily Debris <br /> SERVIC REQUESTED BY /�? ,t, ;t3 �jL� TAX <br /> We <br /> iiiAcce = W-- P. O. # TOTAL CHARGES: <br /> GENERATOR'S::,t -!iCATlOtr e- -___:_ - - __ _ _ _,_ _ �_-c^cec a.._ _cy Oprope•sricng name and ore classified,packed,marked,and <br /> _ - - -- - - c --_ - - 'c Yo• eg_a ops. `I am o large quantity generator,I certiry that I <br /> -- = -- - - - -- _e ^-coa,oroc�icca'e and ihot I have selected the practicable method <br /> - -f _- --_ - -- ___._ - _ _ _ ec -�earr cr4;tee e-vronmenl:OR.41 c-o small ouanfitygenerator,I have made <br /> ;-:_- _• _ _ _ _Z. _ cnc' cc-�C-a'c. Ail used oil from the generator fisted above <br /> ze-e- ___ -_ _ - _ _- j -_ .c ec c*OR o �;:Iv t-W:;;requ red!c cempiy wiih Federal regulations applicable to the <br /> :;,e cs.e?o;beer dscicsed. The customer agrees to pay reasonable costs and attorney <br /> c _ cc__ _ _ ^�_.co, $ y o .` ;declare under Cenci of a•u that the for Is true and correct. <br /> S OSAURECYCLING FACILITY: `Collection Station Industriai Agriculture Govemment Mafine Other Industrial <br /> Oil <br /> Print Narne <br /> auntobith esFavI at I r h t to n above 1' generator t9-the trms a side of this form. <br /> 990/LbOlpi OMI SOAS AMR MaONMA 66V99VVL0LT XVA 9Z:9T TTOZ/ZZ/80 <br />