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FR-E ) 101_-►V L �JRON.NJLNTAL " 'RVICES, INC. <br /> P.O. B.,. :. -: - -- U. .D.O.T.= 14"66- INVOICE # 2 8 0 5 d, <br /> N sca%life. .. 4�nvn_.� =-` D T.�C._ - <br /> A.= 446` Date <br /> SITE A.^:�RESS 2!.LING/MAILING ADDRESS <br /> Customer _ Bra non �__ - _ __._._ Customer Brannon Tire <br /> 4905 Claremont Avenue P.O. Box 1988 <br /> Stockton, CA 9 207 Stockton, CA 95201 <br /> CAL 0001 6 538 ✓ P <br /> E.P.A. , hone <br /> Addition.ai Contacts: 209 4 7-9000 <br /> ike <br /> PRODUCT - SERVICE INFORMATION/PROPER SHIPPING DESCRIPTION <br /> 7 . '4 . 2' • 3G . 45 • 6;. - 90 CODE <br /> 180 • 365 W C CMANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> i ODE j <br /> r n-RCRA Hazardous Waste Liquid(Used Oil) CA 221 C 4f�/3 ZIJv G <br /> Nor-RCRA Hazardous Waste Liquid(Used Anti-Freeze) j CA 134 11.009 <br /> No-R.SRA Hazardous Waste Liquid(Oily Water) CA 223 <br /> Drined Used Oil /Gasoline/Diesel Filters WA <br /> 55.00 <br /> Nor}RCRA Hazardous Wade Sold(oil Cottmwtded Debris, Sod) CA 223 <br /> Parts Washer Service !CA 223 <br /> Nw-RCRA Hazardous Waste Liquid(Brake Fluid) CA 3 j <br /> Wade Rartmabie liquid. N O.S. 3; UN1993, PGII(Gasdr*-Diesel) 31/D018 <br /> I <br /> i <br /> :3 `- J 3r_g :1 55g :1SPF <br /> "e.' < a_; =c Cer'era or Crowiedge ❑ PPM <br /> -ic _=C SAB °aceing/Site Cleaning <br /> eUOF f'� -2-1 Oily Debris ot <br /> SERVICES REQUESTED BYTAX •00 <br /> Acce-' 1112 ' P. O. # TOTAL CHARGES: <br /> - <br /> __ -- - -- - = 'c.e-sr inn;rg^-eme and ore classified.Packed,marked.and <br /> ---- -` - ,r rear c'c^>. r-a`urge cucntiiy generator,l certify that l <br /> prctt:cab:e^nc rhat i have selected the practicable method <br /> --_ ----_ --c _ _e �•as� -_ hea'•n a .^e a-.��c^:mem•:OR..F:om a smaX quantity generator,I have made <br /> __ - ---_---• _ .`___ _: .-_ -- -- -' - ^cca'cr Mused oil from the generotorfisted above <br /> OR:7 c. `s•ec %sc' -co oy w to ederal regulations applicable to the <br /> _-_ _ _ -ne castor sr ccrees to pcy recso attorney <br /> - _ 's os`� noble costs and <br /> `-�- �.. --� -- �° - '� - '._`-'� === -;,':e'ce`ahvo`oe�ur,•'rc'r^.e for of is true and correct. <br /> OISP AL/RECYCLING PA.Ci�'�J Collection•S`ction I inous',rio!`f Agriculture-�Govemment Marine 1 Other Industrbt Lubrtau inp <br /> 44,r 1 Road 306 D" ! ;c a,iirc ( )C4-Herbom San,lode LLC i 1 Eb9 Sky Erfvronmertal ( 121M Cviiry EMI <br /> 6880 S mtl A;e 10Y 9emrvs9a Road 401 W.Ch>mel Road e e � 958' 2095 Na*4"Dr.,East <br /> ^ ` CA fes: 3 Sar,jou,'CA 954,334 ?erecie,CA 94510 5 Fernley,NV 89408 <br /> �. GiD980687at8 408.441 962 CAD059ed310 510541-2128 CAL 000301639 775575.2760 NVD980895M <br /> Nnt Name Generators Signature DrNers Si ature <br /> 1 h i h v red ve f r' to bin above lit generator to theerms on a reverse side of this form. <br /> 990/0501x1 ONI SOAS AKH A110WHHA 66VCSVVLOLT XVA LZ:9T TTOZ/ZZ/80 <br />