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FORM NO. AES(N13 <br />.�,� � r SERVICE ORDER <br />No. N684637 <br />f ASBURY ENVIRONMENTAL SERVICES <br />1300 S. SANTA FE AVENUE n COMPTON, CALIFORNIA 90221 n J310) 886-34UU <br />EPA# CAD028277036 <br />DJXON UNION CITY CHICO <br />840-727-2879 888-F303-884-4 800-733-9043 <br />DATE �c <br />CUSTOMER <br />61 LLING ADDRESS <br />F <br />PHONE .% ' 3 1 � CONTACT <br />CUSTOMER EPA #/) <br />JOSS SITE ADDRESS �/ /G �' Sf/�7r <br />CROSS STREETS <br />Mk oliziR81 <br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS) STATE CODE 221 <br />'NO PLACARDS REQUIRED' <br />ONETIME PICK UP ❑YES or 11 NO <br />RESIDFNCE ❑ YES or ❑ NO <br />CONTRACT CUSTOMER 1-1 YES or L NO <br />PLEASE PAY FROM THIS <br />SERVICE ORDER <br />CUSTOMERNUMBER <br />AMOUNT <br />CHECK NUMBER <br />P.O. NUMBER <br />CASH RECEIVED <br />IRMO N-0 <br />COMMODITY 67 <br />HALIDES e'`�� PPM. <br />❑ NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) STATE CODE — NEXT SERVICE DATE <br />"NO PLACARDS OR MARKINGS REQUIRED' <br />❑ OTHER <br />MANIFEST NO. <br />DRIVER <br />❑ USED OIL AND GASOLINE FILTERS <br />-1-r e— <br />© SA RECYCLING, 33210 Western Avenue, Union City, CA 94587 1-510-487-9277 <br />❑ ALTERNATE FACILITY <br />DRUMS _ DRUM SIZE <br />NO, OF GALLONS <br />TRUCK NO. &RT <br />DESIGNATED TSDF: ❑ASBURY ENVIRONMENTAL SERVICES • 2549 Snot Avenue • Chico, CA 95928 • CALCOW27844 <br />❑ <br />ASBURY ENVIRONMENTAL SERVICES CHICO 11, LLC • 1618 W. 5th St., Chico, CA 95928 • CAD980694103 + (800) 733-9043 <br />❑ ASBURY ENVIRONMENTAL SERVICES-FORTUNA • 20C Dinsmore Dr., Fortuna, CA 95540 • CAL930256136 • (800) /33-9043 <br />❑ BAKERSFIELD TRANSFER INC. • 1620 E. Brundage Ln- • Bakersfield, CA 93307 • CAL000282598 • (6611377-0308 <br />D/K DIXON• 7300 Chevron Way • Dixon, CA 95620 • CAT080012602 • (707) 693-6006 <br />DEMENNO/KERDOON • 2000 N. Alameda Street • Compton, CA 90222 • CAT080013352 • 13101 537-7100 <br />CJ EVERGREEN ENV. • 413-9 N Valentine Ave. • Fresno. CA 93722 • CAD982446882 • (510) 795-4400 <br />" RAMOS ENVIRONMENTAL • 1515 S. River Read • W. Sacramento, CA 95691 • CAD044003556 • (916) 371-5747 <br />ALTERNATE FACILITY <br />USED OIL i USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE <br />€tECYCL D AT OUR SISTER COMPANY DEMENNo/rERDUON IHE <br />LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. <br />•L HEREBY CERTIFY THAT I HAVE NOT M1XED THIS WAS] E WITH ANY <br />OTHER WASTE, THAT TIIE TOTAL HALIDES ARC LESS THAN 10070 PAM; <br />AND THAT THE WASTE DOES NOT CONTAIN ANY P.C. B'S.. <br />M FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL <br />pISPOSAL IF THIS WASTE IS OVER 1000 P.P.M. TOTAL HALIDES. OR <br />CONTAINS ANY PC.B'S. <br />TI,i� is to cerr;ry LhHt <br />, 1Onam <br />Iee 1.described. <br />ipackaged. <br />baalhxiso <br />jn IP Hcc(wdrv4 to 90 apPclayua <br />and tabxjtpdand are3�r <br />the Department of 9oiatiff. <br />' <br />- <br />r'17 s A NATUFIF <br />PnINTNAME <br />