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F, !P%1 rl'; A["(C' <br /> - - SERVICE ORDER <br /> NO. N 9029187 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S. SANTA FE AVENUE -1 COMPTON,CALIFORNIA 40221 ❑ (310) 886-3400 <br /> EPA#CAD028277036 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800-727-2879 888-603-8844 800-733-9043 866-994-6937 <br /> DATE ONE TIME PICK UP [71 YES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or r) NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or 0 NO <br /> PLEASE PAY FROM THIS <br /> -- SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# AMOUNT <br /> JOB SITE ADDRESS CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> IAMOUNTi <br /> NOTES: COMMODITY <br /> HALIDES PP.M, <br /> L NON-RCRA HAZARDOUS WASTE, LIQUID (USED OILJMIXED OILS)STATE CODE 221 <br /> "NO PLACARDS REOUIRED• <br /> NON-RCRA.HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE <br /> *NO PLACARDS OR MARKINGS REQUIRED' NEXT SERVICE DATE <br /> OTHER DRUMS DRUM SIZE _ <br /> MANIFEST NO. NO OF GALLONS <br /> DRIVER TRUCK NO.8 RT <br /> USED OIL AND GASOLINE FILTERS <br /> SA RECYCLING, 33210 Western Avenue,Union City,CA 94587 1-510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF: ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scot Avenue•Chico.CA 95928•CAL000827844 <br /> El ASBURY ENVIRONMENTAL SERVICES-CHICO II,LLC• 1618 W.5th St.,Chico,CA 95928•CAD980694103•(800)733-9043 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr.,Fortuna.CA 95540•CAL930256136•(800)733-9043 <br /> ❑ BAKERSFIELD TRANSFER INC. • 1620 E. Brundage Ln.•Bakersfield,CA 93307•CAL000282598•(661)377-0308 <br /> © DIK DIXON • 7300 Chevron Way•Dixon.CA 95620•CAT080012602•(707)693-6008 <br /> ❑ DEMENNO/KERDOON•2000 N.Alameda Street•Compton,CA 90222•CAT080013352 •(310)537-7100 <br /> ❑ EVERGREEN ENV •4139 N.Valentine Ave. •Fresno.CA 93722•CAD982446882•(5101795-4400 <br /> ® RAMOS ENVIRONMENTAL• 1515 S.River Road•W.Sacramento CA 95691 •CAD044003556•(916)371-5747 <br /> ❑ WORLD OIL-SAN JOAQUIN,LLC• 14287 E.Manning Ave.• Parlier,CA 93648•CAL000102751 •(559)498-0240 <br /> F-1 ALTERNATE FACILITY -- <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named articles are properly classified,described,packaged. marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO,KERDOON THE and labeled,and are in proper condition for transportation.according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br /> •I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 PPM; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATuRE DATE <br /> `I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY PC B'S PRINT NAME <br />