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SERVICE ORDER <br /> No. N 405324 <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 �3 ONETIME PICK UP ❑YES or4NO <br /> CUSTOMERo ?lig.. RESIDENT ❑ YES or'rl NO <br /> BILLING ADDRESS 35'& r->& "10 P,,/ /f- CONTRACT CUSTOMER ❑'YES orANO <br /> PHONEyJ / CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# ( /i�U!/y < a� / AMOUNT �!l - <br /> JOB SITE ADDRESS CHECK NUMBER / <br /> P.O.NUMBER �t <br /> i <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> CV NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIL/MIXED OILS)STATE CODE D <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 /> ❑ OTOER i DRUMS DRUM SIZE <br /> f <br /> MANIFEST NO. <br /> . ,G NO.OF GALLONS <br /> RIVER ( c TRUCK NO.&RT. / <br /> ❑ NON HAZARDOUS DRAIN USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue, Union City,CA,510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> t <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 /> ❑ DeMENNO/KERDOON•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 /> W- RAMOS ENVIRONMENTAL•1515 S.River Road•W.Sacramento,CA 95691 •CAD44003556•(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL060827844 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certifytha e above named articles are properly classified, described, packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and ar proper conditio or transportation, according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department o a sportation. <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 2 12- <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. f CUST ER SIGNATURE / oar <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X � 1�� t 1 B <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR (((���/// / ) <br /> CONTAINS ANY P.C.B'S. PRINT NAME <br />