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Sep-22-10 10:57 From-OK Dixon/AES,.. 17076762339 T-046 P-013/013 F-094
<br /> FORM NO: "a+.••^.5;t•'t.
<br /> ERW
<br /> CE ORDEI
<br /> NO. .N
<br /> AsgURYENWRON EN7AL.SERVJC6S
<br /> T300.S.SANTA FE AVENUE'D..C, .
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<br /> SAN OMPIOj„QALIFgRM1�+" E0221,pi�3)DI,@8B.34W �::3 '••,
<br /> 1 ...r. 1'f18po-748.5744 J -
<br /> _.%! +r,.. . :..:: ,, ••E('Y►1•/1DOzaz77oe6-n'^�Ti 0 NORTHERN CALIFORNIA
<br /> 4 :2Q�.0 1,000-727_2879
<br /> DATE . . ._ . ::. . ..- . ,•..:.,•.• J• },
<br /> --SAi:1JOAQU(1J QOUNiY:-.:
<br /> CUSTOMER ,OINE TIMEPICK.UP
<br /> / HZA, EEPARTMEP(T - : . - : .;_DYESM ONO
<br /> 91LLIN0 AOg /.•. _ ESIDENCE .
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<br /> .. ..:'. :.:11: YES Or O NO
<br /> ^� '. .! CONTRACT CUSTOMER
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<br /> -PLEASE PAY.FROM THIS
<br /> PHONE• moi'" fig,. CONTACT . .SERVICE-ORDER
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<br /> • 'CUSTOMER NUMBER
<br /> �CUSTOpjER'EPAN _ :: �,r', � :. ..:. .. '.. � ,.. .:
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<br /> -
<br /> . MODITYlttt7
<br /> ''NON•RCRA.HAZARDOUS.WAST€,.LfDU1D: SEO ' •... •;•... , J :� / M.LiDr:s
<br /> GE G
<br /> REOUIREDt _ ..-N. QIyM0CE0A143):SJq C E all . . . .
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<br /> ..NONPFiDRANATARDOUSWA$TE_:UO
<br /> #NO
<br /> 111D(ETF.{1'I.ENE:GLYdOI_SOLUF `•P:' , e6. . .'`:,::.`':;, •_.:�.�:::.-: .
<br /> LACAMS OR MARKINGS REQUIRED* IONS)STATE COpE' X193 .
<br /> ].. OTHER ioiV OE MTE .
<br /> : . J ..
<br /> IANlFP_5F NO. - .' . . ..• DRUM6 DRUM SIZE
<br /> RIVER...:. .,.: � ... .. _O.OF GALLON ..�..
<br /> .'NON HAZARDOUS DRAINED USED'OIL"FILTER"'f""•: `'•^'' .r:�:••::::,,.: !TRUCK ND„m,�
<br /> ..1.: ...
<br /> FIECYCUNG.93210(Nes~- ,•.:•`:.:'�9� Jtk:
<br /> COMMERCIAL FILTER ..•.:;` •t" 'r • -
<br /> ._Mltl At'anw_
<br /> ALTERNATE0 .U7IO?I;CRY�CA;51D:4p7+9277 . . `-
<br /> FACIUTY
<br /> SIONATED TSDF: O ALVISO INE EPENOENT OIL-5002 Amhor-Streal•�gWlso,:CA 85502•FgLDOOte/743.(610)-s7B-1Za0
<br /> .D;•BAYSIDE OIL1i,'INC.•210 Enclnel Street•SOMa Cgrz,CA B8OB0•.CA00888138222•"(a09)'427�3778
<br /> :.0..EVERGREEN ENV..41 0 0 N.
<br /> Ahmed Ave.;::Fresno;CA 23722-CAD982446882.,(510)795-4400
<br /> - -:C,K:DEMENNO/KERDOON •200D N.Aldmede Sheet'Compton,CA D0222-CATOBOO73352•(910)'S37.7700
<br /> 17 :•D/K DIXON•7300 Chevron Way._Dbtdn,CA 95620.CATp8Op12602,.(707)693_8008
<br /> -:.ASS OS ENVIRONMENTAL.1615 A.RnenRwtl...W,sacran"*,,CA 98891'.CA0044003858'..(818)371-$7�7 - � -
<br /> . . C7;�ASBURY.ENVIRONMENTAL$ERVICES-•2309
<br /> .. _.• ,..: .1,,,._,,:.g..SoonA ?uO:.L,•hko.'CAss929.!cAtno0927e0a' •, ..,:.,:.
<br /> .... -ALTERNATE FACILITY ._.' .._ ..': •_ ._....... .. .:: .. ..., . ,.. -.
<br /> �IL:USED ANTIFREF2E ANO O1LY WA7Eq WASTE STREgMS ARE .. .. - ... ..
<br /> LED qT OUR'e1STERCOMPANY DEMENNO/KERODON TH¢ bTiVe la lu cergty Thai ll:a a6ave '
<br /> ST.fl¢CYCLER'OF,USED.OIL UI THE_M!E6TERN UNITED 'and IaU01ad,eM are.kP o named arOcles We Prop Orly ckaellled, deecdpad•Packaged,marked
<br /> . STATES OaPerlaianta1TraM eanalxon Imneeortai n according to inn eppllee6le maul&oo m a,
<br /> 31Y CERTIFY THAT"I HAVE NOT MI%ED'THIS WASTE WITH .ANY - the / PORadoa
<br /> WASTE,THAT THE TOTAL HALIDEe ARE TESD �
<br /> 4i THE WASTE DOE9 ND7C TAf THAN 1000.P.P.M.;. .X. J*L` r.:;;'l`
<br /> ON NARY PQ.e'S.. / �•' :���� �- .. ..
<br /> AER AGREE TO ACCEPT THEAODR InvAL C .. .,:._:... 0 N 9Ki11�TUgE ..
<br /> AL
<br /> iF THIS WASTE A8 OVER 1000 HARGE6 FOR LEogL •-..:•j:;7r, l:r, .
<br /> IS ANT P.o.B•e.. . . P.RM;T07AL'RALIDE OR.X..:.'�',,....Je`. . :-, '...� .abr'4: -, _
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<br /> I'd 8ZLL-60Z`60Z Mueg uen ti06e,0 e91760 0l 170 100
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