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I / • SERVICE ORDER NO. <br /> 'ALL! <br /> hl9r 7h0S <br /> BURY A fAft <br /> 1,6N C17-Y OFFICE <br /> ,,f-888-603-8844 <br /> NVIRONMEN <br /> ASBURY ETAL SERVICES <br /> 1300 SOUTH SANTA FE,COMPTON,CA 90221 <br /> 1-310-886-340o 1.1.13 `HAW ROAD <br /> s SrFI ANSPORTER EPA#CAD028277036 <br /> GF° RFSOUF�CFS REPFRRGtL <br /> 11hLIVC:RSAL SWE:.EPING SEFVICF gTOCKTC11d, CA 4`. <br /> P III, SHR{J RD ,g00? �q7-9"'37 <br /> o Gf' RCSOURCEf RGFERRAt_ HALIDES <br /> STOCKTON, CA 9521`' <br /> 0 647`_93:k7 CONTACT NAME ORDER TAKEN BY <br /> (800) ROUTE# TRUCK# IDpO <br /> PURCHASE ORDER# <br /> CUSTOMER# 127 S MANIFEST# <br /> LJN 121 Y NEXT SERVICE DATE CUSTOMER EPA# <br /> DATE REQUIRED DATE ENTERED CAL0002`e6812 D05- I3 J`Tx <br /> x/''1/2009 QTY UNIT PRICE OTYPIU TOTAL <br /> 213!2009 so. 00 <br /> PART# DESCRIPTION $0.00 <br /> OILS �. aDo <br /> WO USED OIL. ! MiIXE1') CHAV <br /> WOSC USFD OIL SERVICE. <br /> 1,2/4 07 F'ER KENT 0 CafY RESOURCE`; TO ItILL GUSTO FR <br /> TOTAL <br /> Ct S>trzt�te <br /> PLEASE PAY FROM THIS SERVICE ORDER <br /> CHECK#��— STATE CODE 221 <br /> CASH REC'D:__� VAO DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILJMIXED OILS)`NO I' a CARDS REQUIRED' <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIO NS)'NO PI p CARDS REQUIRED' STATE CO <br /> OTHER: (? <br /> DESIGNATED TSDF:' , -9277 e yl�� �i/�1,/ALTERNATETSDF: 1 i <br /> CFR: 33210 Western Avenue, Union City, CA 945 7 (510)487 <br /> PN: ___--- :— FACILITY. <br /> EMPTY DRUMS <br /> �•--BSC <br /> DRUMS GENERATOR WASTE CERTIFICATION <br /> THE APPROPRIATE BOX Nation according to aDPliuble State <br /> PLEASE CHECKr condition for tnnaP° <br /> Thio is to certify that the waste described above is properly claasifetl,described.Packaged.marked and IaWled and la in props ,a. <br /> signing below I also hereby certify that U�CI1eCk ONE of the following three boxes) <br /> and federal regulations.By g stomer M +Aa pgp ppm,and Me-ts does not contain any P th" have <br /> !I oil generator/customer e.almmi+w.+te <br /> (Waste g Me total halide content' LESS Man 1, <br /> �p11 I have not mined any of the waste described above with any other hazardous waste, <br /> applicable California used oil management regulations to determine this b true.I agree to accept Me additional charges for Me di- PCBs.I <br /> rnPJad wnh the raquh. mended about Mis ws+le la{ncortect <br /> 1,099l'isn and aha waahe raa m accept the adMiMn.1 charge. <br /> if the Mformeu.n 1 have pr Me total halide content is G0.FATE0.Man <br /> Environmental any <br /> Omer <br /> m a to .but the prasumplio^Mat Ml+waste was miser Mm outer hmrdoua wore.I ag <br /> 0 01,1 have not miaetl any of ane waste dascdbed above with any oMMia w,,a I,Incorrect nerelor ICESOGI sources.Tm the ben of my <br /> have provided Proper documentation to Aaburyl have provided about small quanbtY 9a <br /> Y mdlor corWiJdtellY eaempl otnar nazardoua waste m <br /> for Me disposal of Mis waste II the Information <br /> OIYI GESOG collection tang 1s Way from OIY andlor GESOG sur h a.l provided about Mie waste is incorrect <br /> ld <br /> 1 of MIs waste U Me m4ormati.n I have Pr a the a550CJat�box,) <br /> p3)This waste is from a <br /> tank twhich. It m waste dl from chargehousehfor"pol's etf( and ched knowledge,the only waste oil cone hao accept We additional charges for dispoas <br /> sources.I agr MlJST read the following res I nave determined to W economically <br /> waste oil from oma+ou enerators/eustome naraad to the deg <br /> t.and <br /> (All g sent and Iuhumtt Method the available <br /> reduce <br /> I canilY Mat I have•Program M Place to reduce the volume and <br /> ble to me minimixa+Me present <br /> nerator, storage•or disposal currently <br /> pol Ir am a large quantity to, recficable method of treehnent, seat.generation and sated Ma beat wane mane <br /> vsntlty,generator,l have made a good bIM effort to minimize mY <br /> p cbcable and That 1 nave selected Me p '� � �� ck;,W1 <br /> Me environment.of.111 am a small q _ <br /> �I Date <br /> to me Mat I can afford. _ 1 �- <br /> ;'.%� Driver Signature <br /> Date <br /> ustomer Signature -�— <br /> �________ print Drivers Name <br /> Print Name _" <br />