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FORM NO.AES003, . <br /> _ SERVICE ORDER <br /> No. N 573027 <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 ONETIME PICK UP DYES or/NO <br /> CUSTOMER f RESIDENCE ❑ YES or Z NO <br /> BILLING ADDRESS CONTRACT CUSTOMER /YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> a4 <br /> a SERVICE ORDER <br /> PHONE .! i J 114, CONTACT CUSTOMER NUMBER 71 <br /> ttff <br /> CUSTOMER EPA# f3l17CC7I '71ctT AMOUNT <br /> JOB SITE ADDRESS T7157 CHECK NUMBER - <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> 1 <br /> OTE CO f t - ) � } COMMODITY j.41 , 1 1 <br /> HALIDES P.P.M. <br /> f� NON-RCRA HAZARDOUS WASTE, LIQUID(USED OILIMIXED OILS)STATE'CODE, n� <br /> NO PLACARDS REQUIRED* 3 <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 /> MANIFEST NO. >rj ,7 J7 f ta `� t+'< -- NO.OF GALLONS <br /> DRIVER ) ' �� - '' ); '�*-..^: I (RUCK NO,&RT. <br /> .i <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTFtR <br /> El COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City;CA,510-487-9277 - <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDFi ❑ ALVISO INDEPENDENT OIL-5002 Archer S(reet•,A[viso,CA 95542•CAL000161743.(510)476-1740. <br /> ❑ BAYSIDE OIL Il,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(408)42723778 ' <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave. • Fresno, CA 93722•(510)7954400 <br /> ❑ DEMENNO/KERDOON •2000 N.Alameda Street•Compton,CA 90222•CAT080013352 (310)537-7100 <br /> 0' D/K DIXON•7300 Chevron Way•Dixon,CA 95620•CAT080012602•(707)693-6008 - <br /> O 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 /> -D OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify tha4Jhe above.named articles are properly classified,described, packaged, marked <br /> ..'i&CLED AT OUR SISTER COMPANY DEMENNOIKERDOON 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 P.P.M.; X -. f' <br /> AND THATTHE WASTE DOES NOT CONTAIN ANY P.C.B'S_ CUSTOMER SIGNATURE'.'.' DATE <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 <br /> CONTAINS ANY P.C.B'S. PRINT NAME. <br />