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rUKrA IVU.AWWO <br /> • _ _ _ • SERVICE ORDER <br /> Ea <br /> -= = = No. N 5689070 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE 11lv1PTON,CALIFORNIA 90221 ❑ (310)886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CAD028277036 1-800-727-2879 <br /> DATE - - Q"7 ONETIMEPICKUP DYES or/No <br /> CUSTOMER <br /> RESIDENCE ❑ YES or/ NO <br /> CONTRACT CUSTOMER BYES or ❑ NO <br /> BILLING ADDRESS <br /> PLEASE PAY FROM THIS <br /> q SERVICE ORDER <br /> } tti y�, , CUSTOMER NUMBER <br /> PHONE CONTACT n [e<� °f � f G. <br /> CUSTOMER EPA# (?)" tx'fr­� ie?— t"/11, AMOUNT <br /> JOB SITE ADDRESS i 71 d- Aj� CHECK NUMBER <br /> P.O.NUMBER <br /> CASH RECEIVED <br /> CROSS STREETS (AMOUNT) <br /> ' COMMODITY �U7 `�'' <br /> ES: <br /> HALIDES '1 f/ / P.P.M. <br /> NON-RCRA HAZARDOUS WASTE, LIQUID(USED OI VMIXED OILS)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* NEXT SERVICE DATE <br /> ❑ OTHER DRUMS DRUM SiIZE <br /> MANIFEST NO. ''`r o` f� : " NO.OF GALLONS o LIi1r <br /> rTRUCK NO.&RT. <br /> DRIVER �,:.%�. <br /> r <br /> ❑ NON HAZARDOUS 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 /> D/K DIXON•7300 Chevron Way•Dhon,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 NL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named articles are properly classified, described,packaged, marked <br /> RL ;LED 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.. ..y y. <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY . * �� °L 7 <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 PPM; 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 pgINr NAME <br /> CONTAINS ANY P.C.B'S. <br />