|
• SERVICE ORDER • FORM NO.AES001
<br /> SAN DIEGO OFFICE
<br /> 1-800-748-5744 s — —__— SERVICE ORDER NO.
<br /> NORTHERN OFFICE
<br /> 800-7-ASBURY
<br /> ASBURY ENVIRONMENTAL'SERVICES
<br /> 1300 S..SANTA FE AVENUE • COMPTON,CALIFORNIA 90221
<br /> rsi ! (310)886-9400 • FAX(310) 763-5922 11 Kt34 j,;;';-,1 t
<br /> I . . EPA#CAD028277036
<br /> P
<br /> E
<br /> D
<br /> 7
<br /> CUSTOMER PURCHASEORDER. SALESMAN - CONTACT _
<br /> 7—
<br /> DATE REQUIRED SHIPPEDVIA- - DATE ENTERED CUSTOMER EPA ID.NUMBER HALIDES P.P.M.
<br /> {5(`1i �
<br /> PLEASE PAY FROM THIS SERVICE ORDER
<br /> PRODUCTNO. . DESCRIPTION U/M QUANTITY CUSTOMER COMMENTS
<br /> ORDERED SHIPPED-: B/O
<br /> li_tr II L,{ [rij I t/ r 71
<br /> U!{ItaC IPA: I) tf.L1 .L l v.'v.'L CF, C lieii•:tr€,. c F t s 'f
<br /> i F t xf o _ f I I I I I I v d x
<br /> qit ? [moi'`
<br /> N,A's w*Tht,(4'XM^ni.: nxdr. ,
<br /> WASTE DISPOSAL INFORMATION - PAYMENT INFORMATION
<br /> . NON RCRA HAZARDOUS WASTE, LIQUID(USED OIL/MIXED OILS) STATE CODE 221
<br /> 'NO PLACARDS REQUIRED' GALLONS. ~ � AMOUNT(If any)
<br /> ❑ NON RCRA HAZARDOUS WASTE,LIQUID STATE CODE
<br /> ETHYLENE GLYCOL SOLUTIONS*NO PLACARDS REQUIRED` DRUMS: CHECK NUMBER
<br /> ❑ NON HAZ DRAINED USED OIL FILTERS. ' FACILITY
<br /> -
<br /> El OTHERDRUM SIZE: P.O.NUMBER
<br /> . _MANIFEST NO 71-"('Jtg-T'�1= - CASH RECEIVED
<br /> TRUCK NO. —_—
<br /> ❑ DESIGNATED TSDF. DeMenno/Kerdoon 2000 N Alameda Street,Compton, CA 90222, (310) 537-7100 CAT080013352
<br /> DESIGNATED TSDFx�Adv4n ed Enviro mental, Inc 1357 Whittram Av F an 92, 3 9 9) 356-9025, CAT08002571 1
<br /> ALTERNATE TSDF r �.-= r'i tr( —'C`+7 / AJ,cJc"/lflft. YssG Yl 'Co G 1'Z}r/`CtC>11f GoZ
<br /> NOTES TO DRIVER
<br /> NEXT SERVICE DATE
<br /> 4111 if,{tiEt1Pf'3 1' ._ ,e111 11 ,1 1 'J: ref-J. 0,11_i-
<br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WAST
<br /> Wt'Oft I I.l.. s ) 1 C-'* 1 i tit I�,l ! (r rrr, ) rL 3 It(t`,- 1 1 1 1,-fal_
<br /> WITH ANY OTHER WASTE, THAT THE TOTAL HALIDES AREA• i.4+Fi I t I' f !1, i,')-1r r r tr` " t v 'it} s' 1 I!I F c.!-.
<br /> LESS THAN 1000 P.P.M.; AND THAT THE WASTE DOES NOT -
<br /> )OONTAINANY .S: < ."!f? tsr ' h"I l¢ f )ts s'a}'fi .. { t rte t',*}-I IID t lE S}i is ii
<br /> 'IRTHER'A6RE TO ACCEPT THE ADDITIONAL CHARGES,r, ,Trl l,t'ai. it I-J,'Jf I ;ri i l is ti AI, t,,I-:)t (ItI ! Y
<br /> CLEG L% ISPOSAL IF THIS WASTE IS OVER 1000 PPM
<br /> )1. .,rA IDES,OR CONTAINS ANY P.C.B:S.
<br /> This is to certify that the above named articles are properly classified, described, packaged,
<br /> l j marked and labeled,and are in proper condition for transportation,according to the applicable
<br /> dELfir rnE-6—BY DATE 3 - regulations of the Department of Transportation , ..
<br /> PRINTNAME is L'r ) vC %/ 't. -7
<br /> RECEIVED BY �; DATE '�� 07 SIGNATURE L�
<br /> /-",�' DATE
<br /> L1
<br />
|