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r © R ; '_ ' <br /> r w <br /> ,r.. em <br /> ^tx t 3 , <br /> I Now <br /> e F <br /> INI <br /> . ,.. r r <br /> N, mto�Net v . I ISBURY'ENVme RONIN v" MENTAL SERVICES14, DB °� FORM NO uV�i boo A` I do <br /> A Adme <br /> v.el, a <br /> ',SERU�IME�RDER z 0 <br /> 1r# ? I Not <br /> m 1 <br /> % . rn <br /> . �dome . _ <br /> Al ' <br /> we <br /> WOR MOIL` <br /> n <br /> TINENVI= ONME•NTAI � E�R �I�1'CE�SW <br /> � " met l <br /> yIq <br /> ., JOE H—ACoK• � � ; , � 1300,SOUTH�SANTA FE;� COMPTON CA.�0221 <br /> It ; , Id,MT, 4NIT .E� . , , .LO&ANGELES OFFICE SAN DIEGO .OFFICE. gQ .£3 I <br /> .. <br /> P ' t 800-974 `4495' �'°800-748=5741do I <br /> ' ' ' TRAI SPORTER EPA # CADd2$277036 , <br /> ' o ( �3 � i � { z ° <br /> , IN do I I dome <br /> C PURCHASE PURCHASE, ORDER # ROUTE # TRUCK # CONTACT NAME ORDERTAKEN BY FtALIDES . ' <br /> VER e <br /> ; : . <br /> I Nov <br /> jr <br /> DATE REQUIRED . DATE ENTERED NEXT SERV14E DATE CUSTOMER EPA # " ' BILL of LAQIN6/MANIFEST # r r <br /> OWNr ., ` 3 <br /> }# to <br /> I Net It l4 11 'do <br /> t ; . . . . do <br /> a <br /> IN <br /> � � _ - <br /> ,. <br /> . .: .�v . _ r., , . <br /> . , - s <br /> I me ItoPART DESCRIPTION " OTY ` " 17NiT P,f IC Q Y 4 toIA ',: TOTAL ', doo Not v <br /> TIF f <br /> k. , <br /> I IVv <br /> It r <br /> M <br /> momT ` � <br /> a <br /> or <br /> "'si d,_ lopof <br /> TOTAL <br /> I Veto <br /> ` CAS.H,REC'Dt ZHECIC #, ''` Ii <br /> No — <br /> s" <br /> A FlomI INlimit „ WASTE DISFe do OSL:IIFCJiiVIATiON _ <br /> 4 ', Not �Ills� 11 - dome <br /> IllNON=RCRA HAZARDOUS ASTE,�LIQUID (USED bJUMIxED`OILS) <br /> STATE CODE 221 Need , �. <br /> IN -ANON RCRA HAZARDOUSjASTE, LIQUID {ETHYLENo <br /> NE GLYCOL SOLUTIONS) dImet,k <br /> STATE CODEN do 7: I do. I <br /> I do <br /> OTHER, No <br /> �,� l <br /> 11� Vol Ill <br /> DESiGNA1 ED TSpF. t. ' s1� Net 11 1 <br /> ` VooI / me I ^ Y ' j <br /> it <br /> NALTERNeed— <br /> NATEVIVII = ) <br /> "- <br /> ke , ; NeVt <br /> loom IN _"No <br /> led <br /> % DR4)MS P/U: EMPTY DRUMS FACILITY BSCdome <br /> GENERATOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE BOX) IN do <br /> ;' <br /> me <br /> ell ” I I Ilk <br /> By signing below i hereby certify that: Note <br /> (Waste oil generator/customer MUST= check ONE of the following three boxes) . <br /> IN me <br /> , .,. <br /> 'Dirt lhavehotmixedar11 1 i of the WastedescribedabovewftTianyotherhazaedouswaste; thetotalh511decontentisCESS 'than1 ,0014m- 1 0ppm, and he waste doesnotcontainany` PCBs: ihavecompliedwiththerequirementsof ! <br /> Y <br /> the applicable Callfornia used oil management regulations to determine this is true. I agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect' <br /> Oa21,have not mixed any of the wastedesalbeidabove with any other hazardous waste, the total halide contends GREATER than 1000 ppm, and the waste does not contain any PCBs. I <br /> have` rovidgdpfogerdoc, ttirntationto r)dOilEnvlronmgtalSerylcgstorebutttspresUmpSionthatthiswastewasrRiedvft{ttherhazarrioyNl-swaste, lagreeNeedtoaccep'ttheadditionalctSargesfdrthedisposaiofth(s <br /> p4r , ' <br /> wash Ifthto Ietnf4u + ttsn pve;provideiatioutthlsvya�telsincorrect r ' <br /> cesA IA <br /> o hebestoffA k owfed e;theont waste oil contained i <br /> i3 Tfiisfvast '{sfrbinatankwhichcollec[sw steoilfromhou3 `old do=it yourself`(DIY) 5rtdlor "rood(tionailyeiteinpt'stSialljUahbtygeherator (CESQG) 'sour ,T y n g , • Y <br /> ) _ e • e <br /> frim l�lY1C�SQd�col(ectl3fitankf�soleyfrori('DlYand�BPCES oUrces.`IhavenofinixeiitTiiiwOsteoilwiftianyothe`hazardousviastedYtiVa`Ste`offfrotriother38il'rces agreeto�cceptthcadditionalchargesiordispo�al <br /> of this waste if the'(nformatlon I have pro4ldedaboutthiswaste is inwrrect <br /> INN , 4 (All generators/ customers MUST read the following text and .check the associated" ox:) ` <br /> 4) If 1 am a large quantity generator, I certify that I have program in place to reduce the volume and toxicity ofwaste generated to the degree I have determined to be economically practicp41e and that I have ' <br /> 9 . . <br /> ' selectedihe ` racticablemettlodoftreatment3toia"'geiordispasSlcU2rehtlyavatlable`to'mewhtchminimJzesthepteentandfut {r0threattohuSnaniifeandtheen%JlronmenCOrifaamasmapquant(tygeneratof, l ;' <br /> P IA <br /> vetnac�e a good3aitlt efforTta mintmizebSy Waste generatl6n ansl select the besfwa;te7ianagemenf3nethod tha4 iS ayailableto rise thatt�an afford: ' <br /> 1 o behalf resentsandwarrantsthatbelshehastheauthorit} tobintlCustomer, thattheforgoingdescriptionsofwasteandmaterialsaretrueandwaurate1 , <br /> �This indrwdual3igningin'thespace set forth beow n h p +,, .• ' <br /> as packaVoodoo�r maiked and labeled, are ready for transportation to accordance with applicable stateaind federal regularions, aril that Customer shall abide and,be ountl by the'SfandardTermsand Conditions oed. n theNot reverse met <br /> n <br /> side of thlF�ervice 0�de'r. a <br /> ' IV I It <br /> e No ON III <br /> tNo <br /> , <br /> et / y —do <br /> ic <br /> Customer Signature' Date Driv �,9nat , re Date ' . ; <br /> IN <br /> f <br />