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FRE-NIOU E' -VIRONMENTAL SORVICES, INC. <br /> �cr,d ?3�^::nt ,•,: ?`one lQ_ccq_:_-= EPA lD=CAR0001"1017 <br /> P.U. Boy 21%-4: Phone: - 1•i8 _'00 [:.S.D.O.T.= 1484667 INVOICE # <br /> `,acaN ilie. Ca 9;696-28 Fat: --145-3499 D.T.S.C.r 3544 Date <br /> n-A-%%-.bazw-asteremo%,al.com CA=274461 <br /> SITE ADDRESS BILLING/MAILING ADDRESS <br /> Customer -_-Brannon Tire Customer Brannon Tire <br /> 4905 Claremont Avenue P.O. Box 1988 <br /> Stockton, CA 9207 Stockton, CA 95201 <br /> E.P.A. & CAL 0001 6 538 Phone <br /> Additional Contacts: 209 77-9000 <br /> ike <br /> PRODUCT - ERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> 7 . '4 - 2' - 30 - 45 • 60 - 90 160 - 365 W:C ! WASTE j MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> ,,c"P'-_3_A s',azaroous Waste iqu1 ;;sea �i; L ! :,A 221 ^r �' -�jY J � Z�Tp Gallons <br /> Non-RCRA. Hazardous Waste bqui (Used Anti-Freeze) CA 134 Gallons <br /> 1.00 <br /> '"ion-RCRA '77aza'30us 'wVa5ie Liqul (Ql Water) CA 223 Gallons <br /> _ a leo '_sed 04.: / (Sasai"e Dlesei Fite, /A 55.00 <br /> Nor,:iC;?A -+azxdous Waste Sci:d;_J. _ arnlra;ed Debris. Soii) CA 223 <br /> ..ca .er rer:;;ti CA 223 <br /> ".C--RCRA "mmous Wane LIqu1 (Brake Fluid) CA 343 <br /> Waste Piamrnaoie Laic: N.C.S. 3 UN199 , PGII(Gasolvte_Diesei) 31/00181 <br /> E^-c`; Dr.;-S c.cv:-_e —_ Pe--7cve A� 'A2 5a ZI I Og :3 1,5g Z) 30g :2 55g ❑ S P F <br /> CIo- J 'ec` Q400r,Tec` C -es- ass ZI Fcil Q Generator KnowledgePM <br /> 7rc,)sa0r1c`c, C-e•ges;ACC'alo^ jck lime/Additional Labor/ LAB Packing/Site Cleaning <br /> I <br /> C•ear: ti Labels O ;-i ,y., A/F UOF '-Z �. Oily Debris <br /> SERVICES REQUESTED BY i 313 OI TAX r. <br /> 00 <br /> `%,e <br /> Acce - P. O. # TOTAL CHARGES: <br /> GENERATORS CERnFiCATION: e__c __:_e - =c-e _ ;__ - - -___c - _, - ec c.;o,ope•sripong name and are ciassFied,packed,marked.and <br /> "_a` -_ - _ - `- -= - -`-'--Y • -=_ez <br /> :--=e- - -- c'go`+n— *re;,�<ctio�s. i' em o large quantity generator,I certify that I <br /> -ec be ^o—ccuv ccticabte and that I have selected the practicable method <br /> __ _ __-=_ - - •- -- - _ _ - --- - - __ _ese- c c ___ -_: _^ c-v.en -o-`e envro�rnenl:OR.if I am a small quantity generator,I hove made <br /> -__ _le-_ -_ '•E— - _•-_ s^:C CL,e•= = =c•moo+ cep^"ord. All used oil from the generator Acted above <br /> ---• = c ==__=_c_ - �ec.c ec_ OR a c:::y rTa s-ec.;iec rc camp,y wits Federal regulations applicable to the <br /> - - --- - <ras beer,disclosed. -ne customer agrees to pay reasonable costs and attorney <br /> +es ❑ __ _ - --__ _ _ „e _ cs _ _ _ _ -jc a'c r jac;ore under enol of peau that the for of is true and correct. <br /> :OISPO L/RECYCLING FACILI7Y: -c--e:cfiOr1 Station ^'Inciustrfaij Agriculture Gcivemment I MarineInduasttrlal Lubricating <br /> ting <br /> Othef <br /> ].ean Havers Dan Jose LLCBIEmw <br /> 9S�' + edai [ ]Geanreler E mronmental Mgmi <br /> 401 W Chawsl Roed 2430 Almond DIT'" <br /> • '_{s a, _.fL - r-•�. .- -1.G_ _ �er,hsc•. <br /> CA S!5511:-, J Behrcia Ca. Wig5 Silver <br /> Splines,CA 69429 <br /> C10-541-2125 CAL 1639 7755779001 NVD987358483 <br /> nt Name Generators Signature ers SI nature <br /> db 99dift that I hot@ read - e ut d ave li d oto e r ve it side form, <br /> 990/99011 ONI SOAS ANH MRONHUd 66V£SVVLOLT YVA I TTOZ/ZZ/80 <br />