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SERVICE ORDER <br /> No. N 42 . 427 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH ALAMEDA STREET ❑ COMPTON, CALIFORNIA 90222 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CAD028277036 1-800-727-2879 <br /> / 1-800-933-9194 <br /> DATE ONETIME PICK UP El YES or z�NO <br /> CUSTOMER + `yzG*�yt' , ,✓�c�, RESIDENT ❑ YES or_Z�-NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES ow4�1'NO <br /> PHONE15 -% S !(� `t° CONTACT -i' CUSTOMER NUMBER <br /> / <br /> CUSTOMER EPA# �!/r%G •%��3"a AMOUNT (� <br /> JOB SITE ADDRESS CHECK NUMBER <br /> P.O.NUMBER L <br /> CROSS STREETS CASH RECEIVED <br /> /�•-� / (AMOUNT) <br /> NOTES: (5 �e/�`�Gr� COMMODITY <br /> HALIDES P.P.M. <br /> NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIUMIED OILS)STATE CODE L�J <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> ❑ OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. NO.OF GALLONS <br /> DRIVER ���izidi,� �� l TRUCK NO.&FIT. L <br /> ❑ NON HAZARDOUS 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•CA1000161743•(408)262-1360 <br /> ❑ BAYSIDE OIL II,INC.•210 Encinal Street-Santa Cruz,CA 95060•CAD088838222*(408)427-3778 <br /> ❑ ARTESIAN OIL RECOVERY INC.•2306 Magnolia Street•Oakland,CA 94067•CAL000233905•(510)839-4234 <br /> ❑ DeMENNOXERDOON•2000 N.Alameda Street-Compton,CA 90222•CAT080013352•(310)537-7100 <br /> ❑- OCS-3255 N.Marks Street.•Fresno,CA 93722*CAD980673842•(559)485-5496 <br /> 1Z RAMOS ENVIRONMENTAL• 1515 S.River Road*W.Sacramento,CA 95691 *CAD44003556•(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue*Chico,CA 95928*CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE This is to certify tha the bove named articles are pro erl�f classified,described,packaged, marked <br /> and labeled,and ar in p per condition for transport ondlaccording to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. <br /> the Departntent f ansprtatron. � <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DTE <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X C �` n, S�I <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY P.C.B'S. PRINT NAME <br />