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FORMNO.ArMXtl <br /> -- SERVICE ORDER <br /> ff ELL <br /> NO. N 604224 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE o COMPTON,CALIFORNIA 90221 ❑ (310)8863400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-57444 EPA CAD028277036 1-800-727-2879 <br /> / _ �7 ONE TIME PICK UP OYES a ❑NO <br /> DATE 111 <br /> RESIDENCE ❑YESw O NO <br /> CUSTOMER <br /> BILLING ADDRESS ? CONTRACT CUSTOMER ❑YES or ❑ NO I <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE C c�i�! > CONTACT^-I r�l!�"- CUSTOMER NUMBER <br /> CUSTOMER EPA e GCG�16,y-'717 3 AMOUNT <br /> JOB Sn46DRESS CHECK NUMBEF[� <br /> P.O.NUMBER <br /> f <br /> CROSS STREETS - - CASH RECEIVED -NT) <br /> NOTES: L, _ COMMODITY <br /> HALIDES RPJL <br /> 1 <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILMUXED OI[9f STATE CODE n1 <br /> `MO PLACARDS REOWRED' <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> MIO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> i <br /> ❑ OTHER Loa. DRUMS DRUM SIZE <br /> MANIFEST NO, 0671'3/e' T/ J_j7 NO.OF GALLONS <br /> DRIVER /r' 1 W TRUCK NO.6 <br /> i <br /> ❑ NON HAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLINO.33210 western Ave,".UnIon City,CA,510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> I <br /> DESIGNATED TSDF: ❑ ALVISO INDEPENDENT OIL-5002 Archer Street-Alvfso,CA 95502•CAL000161743.(510)476-1740 i <br /> ❑ BAYSIDE OIL 11,INC.'210 Encinal Street-Santa Cruz,CA 55060-CADG88838222•(408)427-3778 <br /> ❑ EVERGREEN ENV.•4139 N-Valentine Ave .Fresno.CA 93722.CAD982446882.(510)7954400 <br /> ❑ OEMENNOIKEROOON ,2000 N.Alameda Street-Compton,CA 90222•CAT080013352-(310)537-7100 <br /> �IK DIXON.7300 Chevron Way.Down,GA 95820.CAT080012602.(707)893-6008 <br /> -5747 <br /> -❑ RAMOS ENVIRONMENTAL.1555 S.RNer Road .W.Sacramento,CA 95691 .CAD044OD3556 .(916)371 ` <br /> ❑ ASBURY ENVIRONMENTAL SERVICES'2549 Scat',Avenue'Chico,CA 95928'CAL000827844 <br /> ❑ ALTERNATE FACILITY 1 <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to cer6ly that the above named armies are pmpeny clasv5ed,described,packaged marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNOIKERDOON THE and Mbaled.and are In proper condemn Io,transportation.according to the eppQ.cable regulations of <br /> LARGEST RECVCLER OF USED OIL IN THE WESTERN UNITED STATES the Oeparbnelrt at Transportation. <br /> 'I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITR ANY / <br /> OTHER WASTE.THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.: X <br /> AND THATTHE WASTE DOES NOT CONTAIN ANY P.GB'S., US A GNATU E DATE <br /> 'I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR pglNr NAME <br /> CONTAINS ANY PC.B'S. <br />