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FOR SERVICE CALL: <br /> UL—'Iis.*L6 ti t►— SERVICE ORDER <br /> DIXON OFFICE - FORM NO.AES004 8(REV 8115) <br /> 1-800-7-ASBURY JI_ `,i ri r ' _ SERVICE ORDER NO. <br /> FRESNO <br /> 559-498-0240 1421tKi A <br /> CHICO OFFICE <br /> I 800-733-9043 <br /> f ASBURY ENVIRONMENTAL SERVICES ' <br /> 1300 SOUTH SANTA FE,'COMPTON;CA 90221 <br /> i H . GOLDE144ITA'TE UTILITY UQ 1.310-8W3400 <br /> 1 -3278 CONTRAL AVE TRANSPORTER FPA#CAD028277036 4426 FARM SUPPLY DR. $TE 101 <br /> p <br /> v <br /> E <br /> D. PREMO W. CA VASW CERES. c-'A W307 <br /> o f2Gfi 519-3+1x8 12W S70-8446 <br /> I <br /> i <br /> CUSTOMER# PURCHASEORDER# ROUTE# j TRUCK# CONTACT NAME ORDERTAKENBY HALIDES <br /> C. COR14 <br /> TE-REQtARED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# MANIFEST# <br /> =120113 tuIM16 CALOW37919 t3 <br /> PART RI TTION QTY UNIT PRICE QTY PIU TOTAL <br /> V11108C UISEU OIL fiERVICIR CHARGE f 1000 <br /> W ?9� S$024(H) <br /> 111 <br /> � llldt20R s�e� e��cais�__.__ <br /> i 'AQED IJRIVI^R <br /> W"ta HOURS 0:30AM• 3.301"M <br /> TOTAL <br /> II CASH Rkb, CHECK# <br /> i WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILIMIXED OILS)'NO PLACARDS REQUIRED- STATE CODE 221 <br /> NbfS A RA HAi4RDOUSWASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)-NO PLACARDS REQUIRED-' STATE COBE <br /> OTHER: <br /> J "DESIGNATEDTSDF:- <br /> ALT ERNATETSDFItill <br /> -. - - <br /> rSA-RECYCLING 23285 Elthler,Ste.E;He 41,323-02f•AY(H <br /> yward;CA 94541 323-921-4784. <br /> '1 DRUMS PN: EMPTYDRUMS: FACIGTY:. BSC <br /> GENERATOR WASTE CERTIFICATION. <br /> I .PLEASE CHECK THE APPROPRIATE BOX <br /> This[.to CerNy Mu tlla watts 4acnMtl tluve te pppMy tlnNM0.M*Cdbed,WCMaO.d,nwked and fati.IM,and bin proper condplM Iw pvfl"tLMon.accurGmR to,sppllcabla State <br /> and fedwYrepalr)ane tly ehyyn9 Glow NlM naraDYCMiry then: <br /> (Waste oil generator/4Astotner MUST check ONE o1 the following three boxes) <br /> i a111havagqmleadanyoy lM hs.I.dManOed chore went any other hatarcious waste,Me fool halide Content b.LESS Mao 7,001)ppm,snit the waste dw s not Con lain any PC Be.I have <br /> eomP,w wilh M.raqulramenb of Me applicable CalRoml.uwd dl mWe"mint rpulalions to date mina this to Ime.I*,flea to aecepl the addlll oral cheogis for the dbpo Cal of lh is waste <br /> If Me Inform.tlon 1have povtded about thh wines.binc.n ,I <br /> 0 Nal l have not Meed any d the waste We criOad Nona"It.iny CMKha aflda us waste.tins,total hallde contant to GREATER MM 1,000 ppm,aril the wish dMa not.1aln'any PCBa.I <br /> M Me ifie of d d this <br /> Woo Aabvry havlromlMlal Saa ut M to r waste <br /> Isf pryumptlon that Mb wasre wM mlad YnM*Mer hazertloua waela_1yrM t*ucepHhe addltlonaf chayas <br /> la Me tlhpetlY dMls waitaRMilMor.witlw lhava porWeO aDd,l Mb wMleblrlcoiteCl - <br /> f 0 nl This waste.only <br /> MMn•talR ontan edMCb rWe ul ho,n ho.Ilon t k 1.solumo.Mir Y <br /> an Nor CESCG Wly e,erep small q,is.d this mratorA ESGGI aeurcn.To rdmi.. .I. <br /> e Wit of my <br /> RrwwMdpe;the say wpla eR Contained In my DIY/CESGG cdlacdM fink le relay from qY an Nor CESgG+wrws.t Mn wt mind Ihla waste oil wIN any oma hazerdowwa+b or <br /> .MI,e0 hom either.P .Ia,,hwto.CMat dw aldaMal(nMMe for dbpe.el NIn.wail.if McIMpns+lion Ihaw provided abeul Mia..".I.InCormct <br /> (All generators/customers MUST recti the following text and check the associated box.) <br /> 0JH)IllamelMM quar,R•ry.,Mera1w,ICMYy Mall Nveapoyam In placalond. etha volorM andfoalclry.olwab,MvrtedloMedeOreet Mve debmhicallith.r,crtically <br /> 6racticaW units Mall Mve f.laetadlM pruticabla m.Mod of lre+bwetl,alae,a,of dapbaal curtendy available t*tM which minlmlCM chs hent atWf W�Mraat to humeri l,le and <br /> Ms.nvlroa 1;Ce,111 aura quantity genes lm,lnava made isRooiltelth effortaninlhAsa my wMte geneflnbnand aNsctiM wa.0 manage tmedwd Mal is nYlable <br /> to nM MMl an Mlq�,• 1 y / <br /> /n <br /> Cus Si j� Da a Drivir Signature / Data ���� <br />