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SERVICE ORDER <br /> No. N 401708 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH ALAMEDA STREET ❑ COMPTON, CAUFORNIA 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 //}/D� ONETIME PICK UP ❑YES or,<NO <br /> CUSTOMER .TT�t� �t,�T/�YG�� RESIDENT ❑ YES or,:� NO <br /> BILLINGADDRESS y /" L � //g2f� G��`� CONTRACT CUSTOMER ❑ YES or NO <br /> PHONE(�05) j ���� CONTACT CUSTOMER NUNWER , / k7�j <br /> CUSTOMER EPA# �'����P/L /L�J J AMOUNT <br /> JOB SITE ADDRESS CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> � l 9 (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES �`�j/c% P.P.M. <br /> A NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS)STATE CODE <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE NEXT SERVICE DATE <br /> NO PLACARDS OR MARKINGS REQUIRED <br /> ❑ OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. /W — NO.OF GALLONSy <br /> DRIVER c TRUCK NO.&RT <br /> ❑ NON HAZARDOLetRAINED 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 95.502•CA1000161743•(408)262-1360 <br /> ❑ BAYSIDE OIL 11,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 93.722•CAD980673842•(559)485-5496 <br /> 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 Thisis to certi that the above named articles are properly classified, described, packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,a are in proper condition for transportation, according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Departme t If Transports' <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY -y <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 PPM.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. STOMER SIGNATURE DATE 10 <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGALX �a �` ! C'f-i- 'I�_ <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR x / 111 <br /> CONTAINS ANY P.C.B'S. `PRiNTNAME <br />