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FORMNO.ALSW3 <br /> . __ _ • SERVICE ORDER <br /> No. N 555511 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE ,I_, NORTHERN CAUFORNIA <br /> - 1-800-748-5744 EPA CAD02827v`Ci •` 1-800-727-2879 <br /> !1 <br /> DATE "T F —] ONETIME PICK UP ❑YES or/NO <br /> CUSTOMER r =,�s -E. �if - RESIDENCE ❑ YES or/NO <br /> BILLING ADDRESS CONTRACT CUSTOMER/ YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE � � 1 1 LL�-a*Jf t CONTACT =!CUSTOMER NUMBER `f• 4,'�O' <br /> CUSTOMER EPA#/'10 C'-ryd(( 00 1 / AMOUNT <br /> JOB SITE ADDRESS / ! t' 2. "-'l'1` CHECK NUMBER <br /> r <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> ,ES: , `". COMMODITY.& /% <br /> HALIDES c�,/"f✓" P.P.M. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILIMIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* r^ <br /> ❑ NON-RCRA HAZARDOUS WASTE,,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> *NO PLACARDS OR MARKINGS REQUIRED* <br /> NEXT SERVICE DATE <br /> ❑ OTHER / - - DRUMS DRUM SIZE <br /> MANIFEST NO. %NO.OF GALLONS T7 <br /> ` - ' TRUCK NO.B R - <br /> T 7 Ion' <br /> DRIVER _r±-.In" / <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: ❑ ALVISO INDEPENDENT OIL-5002 Archer Street-Alviso,CA 95502•CAL000161743.(510)476-1740 <br /> ❑ BAYSIDE OIL II,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(408)427-3778 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave. • Fresno, CA 93722•(510)795-4400 <br /> ❑ DEMENNO/KERDOON -2000 N.Alameda Street•Compton,CA 90222•CAT080013352•(310)537-7100 <br /> DIK 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 /> U DIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE. This is to certify that the above named article's are properly classified,described, packaged, marked <br /> RL. .CLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are in proper condition for'fransponatlon,according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation <br /> "I HERERV CERTIFY THAT HAVE NOT MIXED THIS WASTE WITH ANY /2 )07 <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X CUSTOMER SIGNATURE DATE -' <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 PRINT NAME <br /> CONTAINS ANY P.C.B'S. _ <br />