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SaP 22-10 10:53 Fry-DK Dixon/AES 7076782339 T-046 P 003/013 F-094 <br /> —y�r— �11rM1�aVt� Y.•YMaI . <br /> Et— <br /> No. N 639186 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE O COMPTON.CALIFORNIA V0221 C (310) 886-3400 <br /> DIXON UNION CITY <br /> 1.600-727-2879 EPA CAD028277036 1-68&.4038844 <br /> DATE ONETIME PICK UP C7 YES or ❑NO <br /> CUSTOMER / ---fir RESIDENCE .0 YES"_Q- (Q. <br /> BILLING ADDRESS CONTRACTCIISTOMER ❑YESOr,MNO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORQERI <br /> PHONE, CONTACT L CUSTOMERNUMBER/� <br /> CUSTOMER EPA 4 ( -�L G�'G C.c/l'7 Y AMOUNT V <br /> JOB SITE ADDRESS 7,f) /Z/- �� '` �iJ CHECK NUMBER <br /> // enZ^lel/I' r..'.. �r71 l.-- P.O.NUMBER <br /> ZF16tS STREETS CASH RECEIVED <br /> - -(AMOUNT) <br /> NOTES: COMMODITY I'lloof <br /> HALIDES ��� a P.P.M. <br /> 03'NOWPICRA HAZARDOUS WASTE,LIOUID(USED OILIMIXED OILS)51 ATE CODE <br /> •NO PLACARDS REOUIREU• - <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> NO PLACARDS OR MARKINGS REOUIREO• NEXT SERVICE DATE <br /> ❑ OTHER DRUMS, DRUM SIZE <br /> MANIFESTNO. r_5 �7O ���` �/ / al C NO.(9FGALLONS �' <br /> DRIVER TRUCK NO.8 HT, <br /> ❑ NON HAZARDOUS DRAINED USED OIL FILTER_ <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,610-487.9277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF. ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Alvlso,CA 95502•CAL000161743.(510)476-1740 <br /> �\ 0 BAYSIDE OIL 11,INC.•210 ExICinal Street•Santa Cru2,CA95060•CADOBB838222•(831) 427-3773 <br /> J ❑ EVERGREEN ENV.•4139 N. Valentine Ave. •Fresno CA 93722•CADEIB2446882-1510)795-4400 <br /> 3-4BEMENNO/KERDOON •2000 N.Alanneda Slroat-Compton,CA 90222•CATOBOO13352•(31 O)537-!100 <br /> C1 DIK DIXON•7300 Chewer,Way.Dixon,CA 95620.CAT080012602.(707)693.6008 <br /> ❑ RAMOS ENVIRONMENTAL•1515 S.River Road .W.Sacramento,CA 95891.CADO44003556 .(915)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scop Avenue•CNCo,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY ' <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE Thi-Is (O cantly MRI VIe above named eglclec are PrOpedy da991hed,desall.od,PRCKaged.lilked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and IAeelee,and are In proder condition Ior posPcHAeon.aeeordin0 to the applleatta re6elaliors of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. Ara Dap menf of Transportation. <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY ) <br /> DITHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.: X_�.,/) `LLT - -'1 b'Z:1' L•''� �� ���/ <br /> ;NO THATTHEWASTE DOES NOT CONTAIN ANY P.C.B'S.- _ bub T01[ER9(ONATURE DA]nTE <br /> 'I FURTHER AGREE TO ACCEPTTHE ADDITIONAL CHARGES FOR LEGAL X. - <br /> 11SPOSAL IF THIS WASTE 18 OVER 1000 P.P.M.TOTAL HALIOE9, OR <br /> 7ONTAINS ANY P.C.O'S. PRIM NAME <br /> 7 <br /> Ol d SZLL-6£Z-60Z 1PUeS UeA lUo6e­10 e£S:60 OL 170 300 <br />