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FORM NO.AES003 <br /> _ SERVICE ORDER <br /> No. N 652455 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S. SANTA FE AVENUE ❑ COMPTON, CALIFORNIA 90221 ❑ (310) 886-3400 <br /> DIXON UNION CITY <br /> 1-800-727-2879 EPA CA0028277036 1-888-603-8844 <br /> DATE ONETIME PICK UP EYES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# AMOUNT <br /> JOB SITE ADDRESS ti `.•' - 'r, CHECK NUMBER <br /> f PO.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES `. P.f'.M, <br /> `Q NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> ❑ OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. NO.OF GALLONS <br /> DRIVER TRUCK NO.&HT. <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 TSDF: ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Alviso,CA 95502-CAL000161743.(510)476-1740 <br /> ❑ BAYSIDE OIL 11,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(831) 427.3773 <br /> ❑ EVERGREEN ENV. .4139 N.Valentine Ave. • Fresno,CA 93722 e CAD982446882.(510)795-4400 <br /> El DEMENNO/KERDOON •2000 N.Alameda Street•Compton,CA 90222•CAT080013352•(31o)537-7100 <br /> ❑ DIK DIXON a 7300 Chevron Way*Dixon,CA 95620.CAT080012602-(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95691 .CAD044003556 .(916)371-5747 <br /> O ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY <br />)SED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certifythat the above named articles <br /> IECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,anare in proper conditon for a spor transportation,properly <br /> classifiedto the described, <br /> edfscable regulations of <br /> ARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br /> 9 pp . 9 <br /> HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> ITHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X <br /> ND THAT THE WASTE DOES NOT CONTAIN ANY PC.B'S,. <br /> CUSTOMER SIGNATURE pAZE <br /> FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL i <br /> tISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR !:! <br />'ONTAINS ANY P,C.B'S. PRINTNAME <br /> L <br />