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FORM NO.AES003 <br /> • _ • SERVICE ORDER <br /> NO. N 583259 <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 EPA CAD028277036 1-800-727-2879 <br /> DATE ' t^7 ONE TIME PICK UP ❑YES or�40 <br /> CUSTOMER J �J l �- "� 111'-17 RESIDENCE ❑ YES or J4 NO <br /> -7 ter' <br /> BILLING ADDRESS CONTRACT CUSTOMER YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> yy SERVICE ORDER ,Jr 7/ <br /> PHONE ; t � t� :T � '' CONTACT CUSTOMER NUMBER f! r fes' <br /> CUSTOMER EPA# 01C%fOI Zb�l� AMOUNT <br /> JOB SITE ADDRESS t 1715 Al, A --+t4 CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> 1- cS COMMODITY ZV/O <br /> HALIDES .�.11-` G`' P.P.M. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED 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 SIZE <br /> .� ' NO.OF GALLONS -3�0 <br /> MANIFEST NO. '�+ 1'l� f —") f�� ' �y <br /> DRIVER TRUCK NO.&RT. �� /-a t <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILE <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 It,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(408)427-3778 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave. ..Fresno, CA 93722•CAD982446882•(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 /> UE '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 /> REs.OLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are in proper condition�or-transportat n accordm to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation a ..,�,�j j <br /> •1 HEREBY.CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY `'!,7 .- '^P`",r- " ~`' '" - �s�' ^"/ ,% / - 1497 <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. US70MERSIGNATURE. DATE <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 RPM.TOTAL HALIDES, OR � PRINT NAME <br /> CONTAINS ANY P.C.B'S. , <br />