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1187 VANOERBILT CIR. #2 <br /> CALIFORNIA COOLANT SERVICE MANTECA, CA 95337 <br /> "Your California Antifreeze Service Company" OFFICE: 209-239-5587 <br /> Transporter EPA#CAR000047167 FAX: 209-239-6316 <br /> SERVICE ORDER: 58705 <br /> Customer <br /> Brannon Tire (SRYKHE99126 5400003) MANIFEST# <br /> 905 Claremont Ave. I Marsh ane 6 �\ <br /> Stockton, CA 95207 D Il(y1 <br /> 209-477-9000 <br /> EPA#CAL 000 106 530 Cu omen: 1260 Contact_Charles Baker Terms_ Net 30 Rea: " <br /> CODE DESCRIPTIONOTY UNIT PRICE AMOUNT <br /> ISO Pre2tana-P 0/50 AIF <br /> 050 Waste Antlireez Pick Up /1 U C- <br /> Tank Serial Numbers: Non Taxable Sub Total <br /> Taxable Sub Total <br /> Tax <br /> TOTAL DUE Ud GG <br /> WASTE DISPOSAL INFORMATION J <br /> ❑ NON-RCRA HAZARDOUS WASTE,LI UID(USED OIL/MIXED OIL)'NO PLACARDS REQUIRED- STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,LI UID(ETHYLENE GLYCOL SOLUTIONS)-NO PLACARDS REQUIRED- STATE CODE 134 <br /> THER: <br /> ❑ DESIGNATEDTSDF: <br /> Cl EVERGREEN OIL,INC.: 6880 S ith Avenue-Newark,CA -CAD980887418-(510)795-4400 <br /> O THERMO FLUIDS: 655 South St nford Way-Sparks,NV 89431 -NVD982510711 -(775)219-7396 <br /> ❑ D/K DIXON: 7300 Chevron Way Dixon,CA 95620-CAT080012602-(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL: 151 S.River Road-W.Sacramento,CA 95691-CAD044003556-(916)371-5747 <br /> f U-SET INDUSTRIES: 977 Sout 700 West-Salt Lake City,UT 84104-UTD982589459-(801)977-0220 <br /> C1ALTE\RNATETSDF: <br /> ❑ CFR: 33210 Western Avenue-Union ity,CA 94587-(510)487-9277 <br /> (All Generators/Customers MUST read the following text.) <br /> If I am a large quantity generator,I certify t at I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be <br /> economically practicable and that I have s lected the practicable method of treatment,storage,or disposal currently available to me which minimize the present <br /> and future threat to human life and the envi 0nment; Or,if I am a small quantity generator,I have made a good faith to minimize my waste generation and select the <br /> best waste management method that is av ilable to me that I can afford. <br /> 'I HEREBY CERTIFY THAT I HAVE NOT MIXE THIS WASTE WITH ANY OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.;AND THAT THE WASTE DOES <br /> NOT CONTAIN ANY P.C.B'S. <br /> I FURTHER AGR is <br /> NAL CHARGES FOR LEGAL DISPOSAL IF THIS WASTE ISO R 100 .P.M. OTAL HAL ES,OR CONTAINS ANY PpC.B'S. <br /> Customer Signature Date Driver ign ure Date <br /> /krlr'lu <br /> &AKName Print Driver's Name <br /> All returned check <br /> re subject to a$15.00 Service Charge. <br /> Allamounts not paid w thin 30 days of invoice af6 subject to 1 1/2%interest per month,18%annually on unpaid balance. <br />