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<br /> FOR RVICE CALL: ERVICE ORDER- r ToFQNo.aESooce(l?evlaoT)
<br /> DIXb?V OPRICE
<br /> 1-800-7-ASBURYPOSTED 1'* _ �_ SERVICE ORDER NO.
<br /> Flf?ESNO J
<br /> -'5$9-498-0240 _ N2041823
<br /> CMICO OFFICE
<br /> 80b-733-9043
<br /> ASBURY ENVIRONMENTAL SERVICES
<br /> 1300 SOUTH SANTA FE,-COMPTON,CA 90221
<br /> H d,a Df PO Ek1T RF'QIS{~S• STUGKfON 1:310-S8cr3400 VAN DE PQL ENTERPRISES- PAI
<br /> P��TQITON.
<br /> 89. SAIRPQRT WAY TRANSPORTER EPA#CAD028Z77038 R-.0. 80X 1207
<br /> E
<br /> ° CA 95,-,05 ST'OCKTON;CA e52oI
<br /> T fig)405.3421 12091944:9115
<br /> CUS- OM R#, PURCq Ir,. R IvR# RQUTE#. :,TR4J. K# ; CONTACTNAMl ORD R_TAK KII3Y LI,. . ': •>
<br /> L9l: IM1+Ad,
<br /> DA ol
<br /> REQUIRE �: DA`TE T R_D •.... N XT. . - VICE DATE CUSTOMER SPA fill•, # +,
<br /> t?1201 . 9/l#f24t# CALQ002M1 S 7 ;t
<br /> PART AI DESCEFInOiN QTY UNIT PRICE QTY PN TOTAL
<br /> 'Da USED,01l AND.,3,ABQLINE FILTERS "y �J� °—'I
<br /> '"� �,d�.
<br /> FEB. 1 'l 2016
<br /> RCE-44E 01 FERENdE'hide 04LON AMOUNT.FROM C-00 rY TANK(4NAREHOUSE)ANO tEWLAR OIL ANK ON SITE.
<br /> BATBATCHE IV i R C)N M EN A L
<br /> # '.
<br /> HE .lT14 rXPPARTNAF, T
<br /> TOTAL
<br /> CASH RECta CHECK# PLEASE PAY FROM THIS SERVICE ORDER
<br /> WASTE DISPOSA4INFORMATION:
<br /> 1 ;•_.
<br /> NQNrRCRA HA?A.RP90o.WASTE,.WAVI.D.(U4I O.QII;IMIXED:O S)eNO PI.ACAR4.S.Rf QUIf1EP`::; 8TATE COpE 21
<br /> 1Vg�I-f3CIAsf f A4f� Ol� 11KA$T ,LIQUID.(�THI(LENE:C�I�YGO :,�OLUTJON9)'.NQ.p�P1�AR�tS 1Q�1ILY:;;STA_je1 E COAC, + t
<br /> 141 A
<br /> SA RECYCLI"210 Western Avinub3,Uhidii City;CA$4587.: 1-510-497-9277: " �' `:•' i
<br /> ,DRU M$:RN.:; �;rlji',EMf;fY-piki"S :RAQIUTYr: +;,-: HSGt�:. ,,: .�;':t :'i :�•;. r
<br /> - GENE�tAT `R' A5T '.0 R .IEf 'A.f..N .
<br /> ` - PLEASE' -HECK THE ApEROPRIATE'6bX . ` : ..: T-
<br /> Tits Is to cartify that the waste d4scnhod above Is property clasaff ed,dsrcrltied,Oat: id,nQarksdand talislaQ,and Is In'propsi co lditkn;f4y tra sportstion;atcordingtoepplf bts 51ei•
<br /> and federal regulations.By signing below,I also hereby certify that:
<br /> (Waste oil generator/customer MUST check ONE of the following three boxes)
<br /> 0 91)1 have not mixed any of the wade deacrlbed above with any other hazardous waste,the total hands content is LESS than 1,000 ppm,and the waste does not contain any PCBs.I hays'
<br /> compiled with the requlraments of the appllgjblr,Califonlla used od rnansgemsnt regulationo.to determine 046.1s true.(apr}s to agcsyt isle additional charges fttr(ha disposal of tiihvnis" ,
<br /> If the Informatlon I Metre provided about thlelddettli Ihcbrrict r `
<br /> a 9211 have not mixed any of the waste deecdbed above with any other hazardous waste,the told halide colilent is GREATER thin 11,0011I and she waste does not contain tiny PCBs.I
<br /> have provided proper documentation to Asbury Environmental Sw vlces to rebut the presumption that this wool•was mixed with other hazirdoui.Waste.loans to accept the additional charges
<br /> for the disposal of this waste If tits Infomaatlon I have prodded about this waste Is Incorrect
<br /> n u?fih w..100rroln&.0 r l lh.aRlll4ll wu1q.41lfrgM hwM.eholo:dod1-your.Roll"(DIY)20(w 99nAlf9nalily axlemPt rmall g4nidd g 0@(gI0r.iFE;KIG)#o4r09p-.To 11N
<br /> knowledlte,thi only va pt!eetl coq Irj in y,q /CE p. Ion tank Is raolsy f P1rl DIY endfor SQG soyrces.I have not rplxep thle syas{e oQ whits cry yllysr hee�w ova►t•rk,
<br /> wsstioll front olhar iwieee.l Yprr'Z r:b1j ga ed d�ii lbi dlgfosN al Atte�iN'te 11`ti �n amfadon 1�tYvprovtU�tf ibdut 116) wrsf1, Ir e!
<br /> (AIS fL_ bo�is/w�tdt>�lers Mll' '`r �i'ttie fllowfiig text�hnd` ecYa 'as ;iitli I�oi�,�: 74
<br /> /h.Q 04)'N 1 im s Brise qusntRy'gsnsrattfr;I artlfy that 1 hav'a prti�am irtplaelto r uc'i the vdune ma toiletry of waste generated to the r"
<br /> I h,w Acle kf9E'{dJbo•cohomlclslly
<br /> ' prictieabN ami Ihat(haus sal�fhs praeygabltr rteyl,oq Of trsapngfl.koMge or e0aposM eurrerNhy,avallahlr♦:tg rns whleh minbmxes the groan and a thrust Chumµl 01s and
<br /> the anvih•ritrlt rAj'Dr,Iditol iudvh' fitli'�iniiatol;fthsti�'thide'•garod(aR�tyHbr!to Ynlnlrillu rely wain pihsratroh and i6lect Iks 64wash ag�"2od 1hi11i.ivillet li
<br /> to meUta q40
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<br /> C m'r Ignafdre :Da'
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<br /> Print Name tint Drivers Name '
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