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FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 568866 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPACAD028277036 1-800-727-2879 <br /> DATE - Io `CK,^ ONETIME PICK UP EI YES or/NO <br /> CUSTOMER d , = +" 't RESIDENCE ❑ YES or16 NO <br /> BILLING ADDRESS CONTRACT CUSTOMER /YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> r SERVICE ORDER J <br /> PHONE ' ; `?' .` rfE-t'lo CONTACT CUSTOMER NUMBER 1st .L Lm 76 <br /> CUSTOMER EPA# CA I rj� �� )l�r AMOUNT <br /> . 7' y ;; <br /> JOB SITE ADDRESS ��-I l t ,3..,,fS.. R CHECKNUMBER) �'y <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> ES: COMMODITY --/ �.J <br /> HALIDES ffAA� 4 - P.P.M. <br /> NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIIJMIXEDOILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEX1-SERVICE DATE <br /> DRUMS _...DRUM SIZE <br /> ❑ OTHERI <br /> // <br /> MANIFEST NO. t�y�+4��'� fR F�,C � - <br /> NO. GALLONS /It// <br /> —� r 27 7 <br /> DRIVER TRUCK NO.&RT. I- 7 <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 Il,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 /> ❑ DEMENNO7K.ERDOON •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 -)IL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named articles are properly classified, described, packaged,marked <br /> R. CLED AT OUR SISTER COMPANY.DEMENNOIKERDOON THE. and labeled,and are in proper condition for ir@nsportgfion,acyording to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. t ! 1 <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANYJ- s <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 RPM; X I "* I` <br /> AND THATTHE WASTE DOES NOT CONTAIN ANY P.C.B'S.. . - CUSTOMER SIGNATURE FATE <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 />