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• SERVICE ORDER • SAN DIEGO OFFICE FORM NO.AES004 B 1-800-748-5744 ` t a SERVICE ORDER NO. N10`i'r040 NORTHERN OFFICE 1-800-7-ASBURY ASBURY ENVIRONMENTAL SERVICES 1300 SOUTH SANTA FE, COMPTON CA 90221 x ¢�+,Fs OFFICE SAN DIEGO OFFICE NORTHERNOFFICE I UNIVERSAL SWEEPING S�� t�ta7au9s 1-800.7ae.s714 1-WO-7-AsBUR 1t13 SHAW ROAD EP 1. 113 SHAW RD EP GP RESOURCES REFERRAL TRANSPORTER EPA#CAD028277038 GR RESOURCES C REFERRAL.. T STOCKTON� CA 95215 STOCKTON, CA 95515 o___._7f3$4) W4T-93ce CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES UN1219 1'<'7 S JOE kosi.o L /QOO DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# MANIFEST# 7/8/2009 7/7/2109 CAL00025681 pOSSSSLbST�y�' PART# DESCRIPTION QTY UNIT PRICE QTY PIU TOT AV WO USED OIL / MIXED OILS 100 JI0. 00 40,,00 WOSC USED OIL SERVICE CHARGE 1 1;4.5. 630 ,3a5 1,45. 00 12/4 07 PER KENT @ GP RESOURCES TO PILL CIJSTO FR DTRE-J. LR*- It a�A C1t:t85 tree?tsn rj*� t �l A D DRI ER P TOTAL CASHREC'D: CHECK# _ PLEASE PAY FROM THIS SERVICE ORDER WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE, LIQUID(USED OILIMIXED OILS)-NO PLACARDS REQUIRED- STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)'NO PLACARDS REQUIRED' STATE CODE OTHER: CRIEVRON _y DESIGNATED TSDF: ' ALTERNATE TSDF: CFR: 33210 Western Avenue, Union City, CA 94587 (510)487-9277 . DRUMS PN: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION PLEASE CHECK THE APPROPRIATE BOX This Is to certify that the waste described above Is property ctesaifi eq descnbsd,packaged,marked and labeled,and Is in proper condition for transportation,according to applicable State and federal regulationsay signing below I also hereby,entity Mat: (Waste oil generator/customer MUST check ONE of the following three boxes) #1)1 have not mixed any of the ward described above with any other hoard...waste.Me total halide co enl is t.ESS than 1,OW ppm.and the waste does not contain any PCBs.I have mplied AM the requiremante of Me applicable California used oil management regulations to determine this Is tma.I agree d accept the additional chargee for Me disposal M this wets R the IMonnllo,l i have pro dtM d about MIs wad is Incorrect ❑42)1 have not mixed any of Me waste d...road abpve with any other hazardous waste,the total halt&content i.GREATER Men I.DW ppm,and the waste does not contain any PCBs.I have provided proper documentation to Rebury Enviromnen re W Services to but the preaumplion Mat this waw was mixed with other hexardoos waste.I a1Nee to accept NO additional charges for Me disposal a this wage R the Information 1 have provided about IMS waste Is Incon.ct #3)This waet.is horn It tank which,clack waw of from household-d.&A,.unelP fDIY)andlor conditionally exempt small quantity generator(CESGG)source.To the best of my knowledge,the only waste it eon W red in my DWI CES QG c.If.ti.n tank 1.ectal from dal and/or CESQG sources.1 have not mixed Mie waste oil with any other hazardous wets or wad oil horn mhM soon,...I agree to accept Me additional charges for disposal of Mie waste if me Information I have provided about thd wage is incorrect (All generators/customers MUST read the following text and check the associated box.) Q W) If I am a large q.MthY generator,l certify than nave a program in place to r.d.c.the volume and toxicity of waste gen entad to Me degree I have determined to be economically Xticable and that I have selected Me pncbcsbie method of treatmem,storage,or disposal currently available to me which minimlxe the present and future threat to human life and ' M.environment;0,if I am s .If quantity generator,1 have mads a good faith effort 1.minimize my waste generation and salad Me beat waste management method that is available to red Met 1 can afford. /g B &-X as1-yV4 Customer Signature 4 1 f Date Driver Signature Date os&N otdni nriv<ret Marne