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rUKMPry --� <br /> SERVICE ORDER <br /> lei 2 M_ <br /> = No. N 596477 <br /> IIIA <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 O (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> I-ROD-748-5744 / EP�A(i7CAD028277036 1-800-727-2879 <br /> ONETIME PICK UP OYES or ❑NO <br /> DATE <br /> CUSTOMER ® " A/• ,T�j T RESIDENCE ❑YES or r NO <br /> BILLING ADDRESS CONTRACT CUSTOMER Cl YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> -}� ^� cif _f / SERVICE ORDER <br /> PHONFi �J��`� 'U" CONTACT �,.J �CM CUSTOMER NUMBER <br /> CUSTOMER EPA# C,4e QO 6z.�273 AMOUNT <br /> JOB SITE ADDRESS / Gc� CHECK <br /> P.O.NUMBER <br /> r <br /> CROSS STREETS CASH RECEIVED <br /> - AM LINT) <br /> NOTES: COMMO TY <br /> HAUDES PPM. ' <br /> N-RCRA HAZARDOUS WASTE,LIOt.7SED IL/MIXED OILS)STATE CODE 221 <br /> •NO <br /> PLACARDS REQUIRED' � _ <br /> NON-RCRA HAZARDOUS WASTE,LIOUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE?33 - <br /> 'NO PLACARDS OR MARKINGS REQUIRED' NEXT SERVICE DATE <br /> OTHER / DRUMS DRUM SIZE <br /> MANIFEST NO. NO.OF GALLONS ,moi d <br /> DRIVER � TRUCK NO.&RT. <br /> —"7 <br /> ❑ NON HAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,510.487-9277 - <br /> ❑ ALTERNATE FACILITY _ <br /> DESIGNATED TSDR ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Advise.CA 95502•CAL000161743•(510)476-1740 <br /> L7 BAYSIDE OIL 11,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD688838222•(408)427-3778 <br /> Syy❑*��FVERGREEN ENV.•4139 N Valentine Ave •Fresno, CA 93722•CA0982446882•(510)795-4400 <br /> DEMENNO/KERDOON •2000 N Namcda Street•Compton,CA 90222•CAT080013352-(310)537-7100 <br /> ❑ OR(DIXON.7300 Chewer Way.Dom,CA 95620.CAT08WI2602.(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1555 S.Riwr Road .W.Secran ento,CA 95691 .CA0044003568 .(916)371.5747 <br /> F7 ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CALOW827844 <br /> ❑ ALTERNATE FACWTY <br /> — I <br /> I <br /> USED 014 USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to comity that the above named arlicles are proppeerrly Gassfied described packaged,marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KER DOON THE and ISIXI d and era W pr COndlbon w transportation,a=rdin9 to me applicable regulators of <br /> LARGEST RECYCLEfl OF USED OIL 1N THE WESTERN UNITED STATES, ttro Onpartmrn(nr'T, ns�4on <br /> 9 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY J` i <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 PPM., X� _ / �� �� <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY PC 8'S.. i ,% CUSTOMER SICNATURF <br /> I <br /> 'I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 PP.M.TOTAL HALIDES, OR <br /> CONTAINS ANY P.C.B'S. PRINT NAA1E <br />