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Payless Auto Repair Inc. 26 N . Cherokee Ln . Lodi, CA 95240
<br /> FoxseRALF cnlC SERVICE ORDER I
<br /> FOR SERVICE CALL L.N ,AL""meoNo�.zeSERVICE ORDERF"F ASSURY EW IRONMENTAL SERVICESMFE COMPTON.CA SCul PSBURY ENVIftCNMENTPi SERVICES
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<br /> JS't]Llgiu PURCHASE ORDERA ROUTE 1 TROCHE COMACTNAME OROCR TAKfN BV ILLLIDB
<br /> CJSTOMERa PURCHASE ORDER N ROUTE# TRUCK# CONTACTNAME r ORDERTANENBY RllIDES
<br /> ";ID OeTE fNTERF➢ a",SERVICE DATE CDSTOAIER EPA# MANIFEST;
<br /> t � pATER. DATE ENTERED NEXT SERVICE GATE CUSTOMER FP4m MANIFESTp
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<br /> OTY UNIT PRICE I QTY PN I TOTAL - //1:
<br /> PARTI DESCRIPTION I OTY UNITPRICE OTYPIU TOTAL
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<br /> _ WASTE DISPOSAL INFORMATION I HMCO CHECK#
<br /> IONRCRA wSARDOU5 WAST LIQUID(USED OILR,IX D CILSJ NO PLACAP.OS REQUIRED' STATE CODE 221 'E I
<br /> LI NON RCMHAZARDOUS WASEGUipI 1f4N SOLl' NS 4GF GW0.$ DISPOSAL N'ORMAT[ON
<br /> RDS REQUIRED' SLATE CODE_ NONACAA=RDOUSWRSTE LIQUID IJSCOOICM1IXEC OIL ,-NO PtACARU5RE0UIFE0' STATE CODE ON
<br /> lFuy{f OTHER. NONACRAHAZARpWEWASTE IIOUOA7HYLENC LI SOLrJTICN51'NOPLACAROSAEOUIRI STATE CODE_
<br /> 6 DESIGNA ED SOP OTHER
<br /> ALTERNATE TSOF: DESIDNATIMS^,F__ _
<br /> S.RF.ICPNG . a.•.. I I a ALTERNATE TS CF
<br /> ORUNSPRI' EMPTYCRUME:_ EACNTV: BSC_ SA'TL
<br /> GENERATOR WASTE CERTIFICATION ORUMSURU fM1:Ptt URUuts_ FACILITiBSC_
<br /> PLEASE CHECK THE APPROPRIATE BOX
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<br /> �ne.ti:yw.q.q,Wymere.....e...µnw PLEASE CHECM.THE APPROPRIATE BOX
<br /> m.uEnl.m. ..m. . (Wane oil generator/customer MUST check ONE ofthefdllowing three boxes) .r.wW,:#i. °.";::<.:a:.".;°.r." ."•'"'°'•-..,'.•'"'.`•"'r.,......,:n,o•,r..,..a::..:„r.,.,,.„:..a...,.�wr,.,,,..n.,,m
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<br /> •••nY� ^(All genera[ors/customers MUST read thefollowingtext and Cheri the assockdAd box.) ^'• °��••+•«",,, ,,,,,, ,,, ,, _. - aW n,:.a..,.....
<br /> ( "�'N l a W(All gmeretars)wrtomers MUST read UK,following ban and tllecK the assorlated e
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<br /> Page 1 of 4 Photo taken on 12/31/2015.
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