Laserfiche WebLink
FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 663983 <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 CAD028277036 1-886403-88" <br /> DATE /Q ' ONETIME PICK UP ❑YES or;gNO <br /> CUSTOMER RESIDENCE ❑ YES or WNO <br /> BILLING ADDRESS __ CONTRACT CUSTOMER DYES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE 0-iv `I7CONTACT_ CUSTOMER NUMBER //A/I.219 <br /> CUSTOMER EPA#_e l /1/l h,S fir !F�'/�2 AMOUNT <br /> JOB SITE ADDRESS�� !, 1Ln may" CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS i-, I T r CASH RECEIVED �f�U� <br /> NOTES: COMMODITY-----JA)0- <br /> HALIDES 14000 P.P.M. <br /> 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 /> Z Z <br /> •NO PLACARDS OR MARKINGS REQUIRED' 11 <br /> NEXT SERVICE DATE f <br /> ❑ OTHER DRUMS DRUM SIZE <br /> NO. GALLONS <br /> MANIFEST NO. / O <br /> A TRUCK NO.&HT <br /> DRIVER__ I:gar - -r — —'T— <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,510-487-9277 <br /> ❑- ALTERNATE FACILITY <br /> DESIGNATED TSDF: ❑ BAKERSFIELD TRANSFER INC.-1620 E.Brundage Ln.•Bakersfield,CA 93307•CAL000282598•(661)377-0308 <br /> ❑ BAYSIDE OIL 11,INC.-210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(831) 4273773 <br /> ❑ EVERGREEN ENV. .4139 N.Valentine Ave. •Fresno. CA 93722•CA0982446882•(510)795-4400 <br /> ❑ DEMENNO/KERDOON •2000 N.Alameda Street•Compton,CA 90222•CATO80013352•(310)537-7100 <br /> Ik D!K DIXON•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 /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certity at the above named articles are properly classified.described, packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and e m proper condition for transportation,according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of spor <br /> •1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X COSTO 5I AT.uRE DATE -r�--� <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. <br /> •1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR pniNr NAME <br /> Cr1NTA1NS ANY PC.R'S <br />