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SERVICF- ORDER
<br /> POR SERVICE CALL ..
<br /> ON OFF£l�C SER4y1t�E ORDEr3 NO.
<br /> ASBURY EN4'iP,r?Nk1EWAL SERVlUE3 1
<br /> i3Lt0 COUTM SANTA FE,COMP1ON.CA 9.
<br /> 7 3t^ rh6-iAU)
<br /> 1RANSPORTEt;P.PA if CAu(j282777036
<br /> CUSTOMER# PURCHASE ORDER# :
<br /> ORDER TAKEN BY HALIDES
<br /> ROUTE# TRUCKI; CONTACT NAME
<br /> DATE REQUIRED GATE ENTERED 6' NEXT SERVICE DATE CUSTOMER EPA 0 MANIFEST#
<br /> PART# DESCRIPTION QTY UNIT PRICE QTY PiU TOTAL
<br /> £
<br /> j
<br /> TOTAL
<br /> CASN RECD: CHECK#____v�
<br /> WASTE DISPQSAL iNFQRMATiCJN
<br /> 1 NON-RCRA MAZA.RDOUS WASTE,LIQUID(USED OIUMIXED OILS}`NO PLACARDS REQUIRED" STATE CODE 221
<br /> p NON-RCRA HA.Z.ARDOUS VdASTE. LtG2t)iD(cTPIYLENE GLYCOL SCJLUTIONS)'NO PLACARDS REQUIRED' STATE CODE
<br /> —
<br /> DE5IGNATEDTSDF: � ----- — �
<br /> i
<br /> ALTERNATE TSDF:
<br /> SARECYCLING. So2j0Westein AV9ilU9,Uninn City. CA94[27 10-487-9,77
<br /> :�3t'.UMS PlU: EMPTY DRUMS:,- FACILITY BSC_ _ ��J__ ,t
<br /> GENERATOR 'at'6+.5TE CERTIFICATION
<br /> PLEASE CHECK THE APPROPRIATE BOX
<br /> Ynix ix to cEnly that Ne want.drtncdhod»tiove is P+oprdY daefih.d.dEscnbed PackeTe'f nta!heY anti iabNeS,a.tt is in propelcondotoo to,nrana0tircnrn.,auord(egt .S pt.abb>Stzp.
<br /> m+d oid"Al ligolt1t,ni By a]9nln9 Wry,i sort hall"comfy that
<br /> (Waste oil generator/customer MUST check ONE of the following three boxes)
<br /> 's'i!tura n8 maedany Olin.riaate d.anfibad above with any_othar haza,di,,"aril.,4n.total Olin"content is LE 55 than 1.000 Plop,and tna waste dogs not contaui an,PC6s i her,+
<br /> +emt"hod-Ah the regw,t ran"of tho eppiic.W.Ca?nornma used tilt man.prolnt 1e90,ihons to detemv s this£,true agro.!o arcapt the addiGnnal.hanger forth.d+apasai of Aur waste
<br /> f£Ike+n,/ircfianOn f XA4a j}!Gvjd,d atipVl It1+e W.afiie li lliCn�ra/'1
<br /> pJj f h r.¢not mixed Ary Orin.Wast,chng,ibed atmve w,fit any Diner nazutdnus v,aate,<ha total[,.tide contend is GREATER than 1,0* ppm,.,to the waste does not Contain any PC a, P
<br /> :m ivq,ldnd{neptll[hMUIMf(+tali+Jl1 t0 Q4vrM1lfy Elryl[Pnm{lfl4it SCR'tCae(U l9b(i1Yha pIB44Rlp1lOn Sit&t thjy WTSt9 Wa3 Rtiz9d(V11h Olhel tldi 2Y(JOf15 W ARiP 1 d9(€N to.iCCB[}t tnC.dd:tlLNtal ChaY98v
<br /> _.r!0e oixpp.a of it...WAet.iRhs trfxmAOoi}1 have proridmJ ahoi�t mta wash is mcor£.ct
<br /> ' .3l rtn"y .tri+s frdrh a tory which entad,wa.ta.Thom housrhold`do UY.o tsetYITnYl aridity,COndif ora 1,ex.mpi.mag quanIIty g.nerator{C'E50GI aoorres.T.11,0 best Of mp
<br /> loo,whfdg.,th.w+fy statim oil utu}taGIAD(n mY OIYt C6S(}G coilattloh tank issoi.y tram DAY enmo CESGG.o,,r,,,_t have not mia,d+F.iss wacirz oil w+tR any other ho vrdsoa waste or
<br /> waste on Rom othA loumfai Tayse10accoptth.sodh[ooaf Charges fOra9aposai of this iaat8@ the h+form n.aI here pravrded at7ovi this wart,is irmatract
<br /> (All generators/customers MUST read the following text and check the associated box,}
<br /> sa;
<br /> ;it aro'IaYg@ iisanhty RonoB<af.I Cattily that I na,o a Program In place to reduce the volume and loxltiry tit waste yanRratCd to pia+fErateo i harm detanninsd to be rconomiralVy
<br /> 1"".0"I'd roar tnay.0,141ird0.prarticetaO Mfir5d Of tr,ab"111,%V3a9..fit Irstrit5.[Ctlnarnli ieinlyt8 to m.Which mloirwty l mo. re%rot and lot...t inn 1,Knmdr alp end
<br /> e/birUnfRMt;Or,Ifd am 3 SrtLNI ivoloR y 0"it tor,I hayo mann a."rid faith Offtin to Mortara,for.4%fo 3eRe(ffi!0E and it'i"t tnL-bd&t Warto.MArl tkj84i1Eni onetilPd than Is 64 aijaFle
<br /> r»+,enat I CAh offard -
<br /> Custotmer3igrEatarm +` Date
<br /> DriverSigm�iture � Data
<br /> Print Drivers Name _ ____._ ..........
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