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SERVICE ORDER <br /> -= - No. N 405255 <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 DYES QFrN0 <br /> CUSTOMER RESIDENT ❑ YES o-105-NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or NO <br /> PHONE� CJ �— VFz CONTACT .l CUSTOMER NUMBER <br /> CUSTOMER EPA# ZI 2 AMOUNT /�G �— <br /> JOB SITE ADDRESS CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS)STATE CODE <br /> O PLACARDS REQUIRED* <br /> �* <br /> LSV NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE W U <br /> ❑ OTHER �� DRUMS DRUM SIZE <br /> MANIFEST NO. Z��i L��// NO.OF GALLONS "`xU /l <br /> DRIVER t ' C. TRUCK NO.&RT. 2L <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 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 93722•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 This is to certify at the above named articles are properly classified,described, packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled, a re in proper co ition for transportation,according to the applicable regulations of <br /> LARGEST RECYCLES OF USED OIL IN THE WESTERN UNITED STATES. the Departure o Transportatio <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 <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. IXSTOMER SIGNATURE DATE <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL Xe <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR J (. <br /> CONTAINS ANY P.C.B'S. PRINT NAME <br />