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Sep 22-10 10:54 Froe-DK Dixon/AES 17076782339 v T-040 P.004/013 F-OS4
<br /> _... "� SERVICE ORDER
<br /> No.,av .6.52791
<br /> 'ASBURY£NVIRONMENTACSERVICES `. - -
<br /> 1300 S.SANTA FE AVENUE O-COAIPTON,CALIFORNIA-100221,.1a 131b)'BB6.3400 ' '"
<br /> DIXON
<br /> +� 1.WO.727-2879 .EPA CAD028277D36 - - .•.'•••.UNION CITY. .
<br /> DATE - .:...'L •_ ' f< • L:G;'..5'� :.:'
<br /> -ONE TIME*P UP ` p VE9 a t1 NO
<br /> CUSTOMER / � .. . .
<br /> •- /•x . .. -:. RESIDENCE �0 YES a ONO
<br /> BILLING ADDRESS ,. _ . ....,.. . .. .:. .. ... .. . .
<br /> ." ,- ,. •• �•CONTRACT.CUSTOMER '[3 YES or O No
<br /> :` PLEASE PAY FROM THIS
<br /> PHONE�a ? f '
<br /> •-•"•- • ..;:SERVICE:ORDER,
<br /> -'� �" ° CONTACT . n.J. .. . • CUS70MERNUM
<br /> BER
<br /> CUSTOMER EPA
<br /> ..:6_'G G.•CV r,�.. 1c`.9. ":
<br /> AMOUNT
<br /> �-- ;.....,;.. moo.
<br /> JOB SITE ADDRESS .. .•.:� .I . .' . ..... .. :, ;,t
<br /> I-L✓.':. .;�ri,;' ' ` I :X.' ;CHECK NUMBER
<br /> P.Q NuMSEIT-,
<br /> CROSS STREETS • .. _ • . :r'.-
<br /> NOTES: - . . .. . _. .. :. .. ,.. . . - * . "
<br /> ';��gSFipEDE1VED
<br /> .. _. .... . :. - ... ... . �. _.. �' COMMODITY_ >�sG,/r-•
<br /> . HALIDES �!G•GG. 'EP.M.
<br /> J, ON-RCRA HAZARDOUS WASTE, (USED�014JMD(E�OILS)STATE.COOE '221.—
<br /> O PLACARDS REOUfRED• .....• .:.:.: - . ' • .-..
<br /> 7':NON-RCRA HAZARDOUSWASTE,:LIQUID TET7iYLENE GLYCOL;SOLUTIONS).SrAJE CODE .: r.:. ....: "..- . . _
<br /> NO PLACARDS OR MARKINGS REQUIRED•: ^: '.- '-" . _ .:
<br /> - � FJIT 3EFIVI0 •DATE'
<br /> I OTHER
<br /> IAN1FEiS7NQ .. .. .... ._, .. . .. .
<br /> SMS ` ;gRU(N61TE ��
<br /> OWN.
<br /> RIVER � -.. .1.,� i�..t .S/�"f.^-� I r f:�•?NO.,OF Ll'ANS_�^}�-�e"'�:r,.. '
<br /> _NCK NO.8 RT
<br /> NONHAZARDOUS:DRAINED USED OICF9LTER
<br /> -COMMERCIAL FILTER RECYCLING,33210 VA MIXIM AvelKip,URIcn.C4.,'Cq,:5/0487-Y27Z
<br /> .ALTERNATE FACILITY
<br /> iSIGNATED TSOF: ❑ :•AWISO INDEPENDENT OIL -$D0.'(Arche(:Strew,t'.lVW80,x:A95502•CAL'00018/7A7.:f3(0):476-.1740
<br /> 0 :BAYSIDE OIL-11,INC.-210 EnClflerS116eC%Senle Ciuz,`CA"85080.' '
<br /> .CADDB962442282831)12I+3779 .
<br /> . ❑. EVERGREEN ENV.:-4739 N.-Vajentine Ave, s Fresno;GA-93722.:CAp982446Be2 (510)•7854400
<br /> �•'DPMENNO/KERDOON 2000 N,Alelnede Street•CoMplon:CA 90222•.CA(OBDO13352.4310)'53777-100 "
<br /> D/Ic DIXGN:73DD Online,Way.Doyon,CA 95620.CAT080012S02.(707)693-8008, - '•�
<br /> • ❑=RAMOS ENVtRONMENTAL.1516.S;Rnisl.Roed :W.Sacramanlo;'Cq 96697::Wg044003556'.T918)371v^I47
<br /> -%A 95"1;.ENVIRONMENTAL:SERVICES%2$49 SColt Avenue:'Chlcc7 CA.959264 GAL0006278'44 -:':• •-':
<br /> [!' ,ALTERNATE FAC
<br /> oil-,u9Eo AN7IFAEEZE AND OILY WATER WASTE STREAMS ARE '� ''� � ����J' ,! � �� ,
<br /> OLEO AT Obp SISTER FDMPANY.DEMENNO/KEp000N INE ..Thle•I!In eanl(y etxva named ankles me proppaady Claealfi d,d.UtrJbed.packaged,M.,,,
<br /> :ST R2CYCLFR OF USED OIL IN THE WESTERN UNITED STA7Eg;�and.leheletl..pnd.or proper corWllton br tmnepaHao
<br /> atlon.aerding to the appfC=e raguUlbne of
<br /> .q?Pa ahem of T enopa leuon. c
<br /> EBY CERTIFY THAT I.HAVE NOT MIXED THIS WASTE WITH ANY � � � '" '�' ��"��'::� 'K"' -
<br /> .w
<br /> HEA AGREE TO ACCEPT.TNE ADPRIONAL'CHARGE$FOq LEGAL•r�-?.. '�'�
<br /> .AL IF THIS WASTE IS;OVER 1000 P.P.M.TOTAL�MALIDES, OR ,X -- '" , �( )y "./ l�l i' �
<br /> NB ANY P.C.6'3. .. . ��.d.," :, •..•'`:
<br /> .. ..r.,tiny^ t a PPoNI w1ME
<br /> _..r. ................. .. ... .. . ... .. .. .. � .. , ,._....�_..
<br /> 6'd 8ZLL-6£Z-60Z ;PUSS UBA fJ059a0 BZS 60 OL 40 300
<br />
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