Laserfiche WebLink
FREAMOU ' E -VIRONMENTAL S6RVICE5, INC. <br /> ,�entlPa rr.enclo,: Pnene: 8 'nz9-3EPA ID=CAR0001�101 - <br /> P.O Roy :4-5 Phone: "J t lt__"00 C.S.D.O.T. = 148466, INVOICE # <br /> aca\ille. Ca x5696-_8'S Fac "-448-3199 D.T.S.C. 3544 <br /> ultu.hazu'a;teremo�ai.com CA#274461 Date r�S .17-/L <br /> °ESS Brannon Tire BILLING/MAILING Anon Tire <br /> Customer Customer <br /> 4905 ClaremorIlt Avenue P.O. BOX 1988 <br /> Stockton, CA9 207 Stockton, CA 95201 <br /> E.P.A. _ CAL 000196 538 Phone <br /> 209 77-9000 <br /> Additional Contacts: <br /> ike <br /> PRODUCT - ERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> • - 2' • 3C • 45 • 6C • 90i80 • 365 W'C WASTE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> ri cM CA 221 <br /> CODE <br /> C i /S O ZZ <br /> Nc,-R-� Hazardous Wase Ligji 'Used Anti-Freeze) CA 134 ns 1.00 g <br /> Non-R.CRA Hazardous Waste aqui (3ty Water) CA 223 Gauons <br /> Drained Used IGasoline I I ers <br /> I <br /> Nor>-RCRA Hazardous Waste Said(01 alrnin4ed Debits, Sad) ! <br /> Pals as er ce CA 223 <br /> Non- U azar us waste Liquid(braye Fluid CA 343 <br /> Waste ILKW. N 0.S . 3, UN199 , PGII(Gasokx Diesel) 1/D018 <br /> l,'• <br /> -e = Re^-cve A A2 5a J ug :D 15g Z) 30g Z7 55g ❑ S ? F <br /> -es- :1 Pass ZI Fci! ZI Generator Knowledge 3rppm S <br /> C--o-oe:/Acc;tic! ,:ck i e/Additional Labor/ LAB Pecking/Site Cleaning <br /> �`ec ti _cbe,s Oil 'v _ A/F UOF Z Oily Debris <br /> SERVICES REQUESTED BY 13 4 1 1;0- Q } TAX <br /> We <br /> Acce t P. O. # TOTAL CHARGES: ZZ <br /> GENERATOR'$CERT'F+CATION. --,_. _e=__ -_ - __- a _ _ __ - - __ _ - -___ c _ zezzncc,e cv o•oper shipping name and are classified.packed,marked,and <br /> :'l am a large quantity generator,I certify that l <br /> ___ __ __ -- - .. _ e- _ __ _ Ca!iy prac':cab'�e and that 1 have selected the practicable method <br /> - - - _;'e,e"_-' -'_"e=' = 1^.eo o-•d I e environment;O.R.if I am a small quantity generator.I have made <br /> ___ - -' --_=_ _- - -'•'e="-`_" '_="- c_�-s-'""e'-c.:'-c =te o .e and cf!ce^afford. All used oil rrom the generator listed above <br /> - _ ___•- =- _-_'-' _ '_ =c_-_--___c_ _ __-_ OR c'ac'.Giv•ho';s rea:;'rec to comply with Federal regulations applicable to the <br /> _ __='__- _ - _- - = s" -- c -' cs'e*:cs'beec disclosed. 'he customer agrees to pay reasonable costs and attorney <br /> - - -- _ - _ -- - = e _ -_ocre unde'penal of e u that the forgoing is true and correct. <br /> OSAL/RECYCLING FACIL!-Y- Collection Station` Industrials A riculture Govemrnent Marine Other Industrial Lubricating <br /> 0e PRW Smf?w 1021 Berrpma Road 401 W.Channel Road 2430 Almond Drive <br /> 35P+8 2 *work CA 34567 3 San Jose•CA 96133 4 Ber>icie,CA 94510 5 Sliver Springs,CA 89429 <br /> -AD9-_esgle 510-7954400 CAD 708 40&441-962 CAD 0 51 - t39BiM9 77557'!9001 MtD9e2358483 <br /> Prin tot's Signature Driver's Signature <br /> 1 herebyt that I have read an have thea i to bind the above listed generator to the terms on Signature <br /> verse side of this form. <br /> 990/T901P1 ONI SOAS ANH AfIOXH I l 66h£8tVLOLT XVd 0£:9T TTOZ/ZZ/90 <br />