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SEP-20-2010 09:48A FROM:YANDELL TRUCKAWAY T 2098355060------C TD:4683433 P.3 <br /> FORM NO.AES003 <br /> ., SERVICE ORDER <br /> Lu a NO. N 597 .63 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S. SANTA FE AVENUE o COMPTON,CALIFORNIA 90221 o (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CAD028277036 1-500-727-2879 <br /> DATE ONETIME PICK UP OYES or ONO <br /> CUSTOMER �. RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS CONTRACT CUSTOMER O YES or ❑ NQ <br /> PLEASE PAY FROM THIS <br /> �. SERVICE ORDER <br /> PHONE `� CONTACT " + _"> '"** ck , CUSTOMER NUMBER <br /> CUSTOMER EPA k { 1 '4A` "f.rJ AMOUNT <br /> rt ,� +` • � <br /> JOB SITE ADDRESS CHECK NUMBER <br /> PO.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> IAN40L1NT) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILIMIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> 13 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. ,E :r'' t y? '� I NO.OF GALLONS <br /> DRIVER dr.' TRUCK NO.&FIT. <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTER <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)47&1740 <br /> ❑ BAYSIDE OIL 11,INC.•210 Encinal Street-Santa Cruz,CA 95060-CA0088838222*(408)427-3778 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave. * Fresno, CA 93722•CA0982446882•(510)795-4400 <br /> ,0-'DEMENNO/KERD0ON -2000 N.Alameda Street-Compton,CA 90222-CAT080013352-(310)537-7100 <br /> ❑ DIK DIXON*7300 Chevron Way*Dixon,CA 95620.CAT080012802•(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95891.CAD044003556 .(918)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue-Chico,CA 95928-CAL000827844 <br /> O ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This IS to certity that the pbtSve named articles are property classified,described,packaged, morkod <br /> RECYCLED 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 DepartmePZ of Transpwtation. <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY `� .•�j Ac'/ <br /> -- J <br /> OTHER WASTE,THAT THE:TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X '+±r->v' '° �A. <br /> AND THATTHE WASTE DOES NOT CONTAIN ANY PC-B'S.. v. CUSTOMER SIGNATURE DATE <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FQR LEGALx <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES,.OR Xi i '¢ <br /> CONTAINS ANY PC.B'S. PRINT NAME <br />