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` 2012-08-20 16:04 >> 2094683433 P 6/7
<br /> Aur20-12 15:40 From-DK Dim i7DT6782339 T-309 P.002/003 F-775
<br /> SERVICE ORDER FORM NO AEWW-r,0"I)W)
<br /> FOR SERVICE.CALL:
<br /> OIXON OFFICE SERVICE ORDER NO.
<br /> t-800,7-ASBURY _ _ -
<br /> 1NIONVYOFFICE a f�-
<br /> 1-888-603.BB44 ©r
<br /> `oNICO OFFICE
<br /> 90p-738-9D�t3
<br /> ASBURY ENVIRONMENTAL SERVICES
<br /> 1300 SOUTH SANTA 9E,COMPTON,CA 94221.
<br /> 1I$,k4F',?i�C3IWj4 FSC,;1_IRI, 1-310-88((3400
<br /> 1
<br /> ,00 AUTQ 4-1 ot'7A l�l�f?'
<br /> 1 RANSPORTER EPA it CAL)02B2�!036
<br /> 10014THL'I'tfV0 C No' t 7'F2�t�'�r. Crr1 CIS Lia
<br /> T (21701 i.�rC.alrla:1
<br /> CUSTO ER# PURCHASE ORDER# ROUTE# I TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES
<br /> itnlJ�1;C� ' w to 0,,71 2, t;Y Lzkvio
<br /> N7 REQ01RED DATE ENTERED NEXT SERVICE DATE CUSTOMER
<br /> EPA MANIFEST#
<br /> T11�US'wr 7/vlr�ul:' �:ri.C'u1J:�?i'l1Eb.^ ) c/�l � ,✓!Jk—
<br /> At"scRl>� ION QTY UNiT PRICE QTY Plu TOTAL
<br /> PART#
<br /> ,'i�i r�[_I :�Id ��-Tr;.j{-'1'FtUlvl lF:l�.��✓i•IL7!'f IC4'J(ri�1 'a .'T.Sr;,Oct 49.e�6
<br /> :a;w.0i`T'i�tl r•
<br /> F
<br /> USELl IL Ar 41) F-11_�"FRS I
<br /> :IXIL'6 ('FN DRUM'UM 1 fi_2"j:�Ii i � �.,.1225.00
<br /> TOTAL
<br /> CASH RECD: (—,HECK# PLEASE PAY FROM THIS SERVICE ORDER
<br /> WASTE DISPOSAL INFORMATION STATE CODE 221
<br /> NOWRCRA HAZAROOUS WASTE,LIQUID(USER OILtMIXED OILS)"NO PLACARDS REQUIRED"
<br /> NON-RCRA R 1p 5 AST J,LII IID(ETHYLENE GLYCOL SOLUTIONS)^NO PLACARDS REQUIRED' STATE CODE.;
<br /> OTHEPt: r.
<br /> Df;SIGNATED 'SDFa . ' '�' +
<br /> ALTERNATE TSDF l
<br /> SA RECYCI-1NG: 33210 Western Avenuo,Union City,CA 94587 1 510-48?-9277
<br /> DRUMS Plu. EMPTY Di2UMS:� FACILITY' t t ESC
<br /> GFNERAYOR WASTE CERTIFICATION
<br /> PLEASE CHECK THE APPROPRIATE SOX
<br /> Thin is iO certify that the wnetu daietibeQ abova ii properly claieifiad,dviGtiped,paeaaged,nwtkod and labeled,-,)it Is In prepor aoodloon lot trdn►portaoan,.amrainp to applic»hW Stale
<br /> end lodarAi ragulatlans_BY nlrinlna bulow I ai0o 110-111 CIPM y(hat'
<br /> (w4ste 0711 geraMtorf CUStomer MUST check ONE of the following three b=S)
<br /> 0 9471 I halvfr,noa mialyd any a w■wma auscrlhad above with any oil-or h-ladoua waalo,the lot.!hnllau control CESS titan 1,6016 ppm,m+d 71)10 waetu open nor u'.di a dny of imi t have
<br /> wmplloa with thu roqutromvots ar Ina apppcable Caplomie uaed oil h,anaaamant rogil,gltmt+to ocimninv mir It,k um I zarau to accept trio adaitlorial trim j7trr for uin aliponal or thU
<br /> it too Wfonnatlorl I have provided about lhie WMIO It'htoorrrtcl
<br /> a 9211 have not mired any of Iona went.daacrlbod above with any Ott,"rularenum wdt4,NW tubi hAWde conlurtl isGREATER than 1 pp
<br /> 00Q m,and flrr want.dans not cmit.n any I"Cds.I
<br /> navy prGv em pr"41(do6umrntadon to Aunar Fnvironmre+tW Servlrr•a la rabut Tho p(esumrnl(Nt 111911)110 waela wet IMYed wlut akar hitrd ntaua waste. aarod to accrrn Ill,,ad lioWm ctrerur•
<br /> lar the ala polo[at No wool lc 11 tlw irdannrtlnn I kava provinaa ano„t 71)1710 waMe tr k,ertrreet
<br /> Q
<br /> 131TMG waetu ie from a tank villieh Golle6lf waato 911 from houeulNdd"dodi-yam lair'iDIY)an4aw Cnaditionally"'o" Pot man qudnniy 9a Aerator 1lw9o�1 uthuir�rcue.To ttta beet of my
<br /> knowledge,trio only weata ail t:oglalnuti Irl my DIY!CRtRgG cellAatYa,rank a alloy fro,n Ply andlor QOQG ewreva.1 hava not mien!!thJs wiate all wlgl any ulll itr haardpua waata M
<br /> weyra all from toner 011ma.I clogW accapl We at7 IjaIA1 cheroms tole 1.,81 or tela walla 11 tltn Infornimian I I-proviaad about thin wnsto Ie 1nrorract
<br /> (All generatorS/Customers MUST react the following text and check the associated box.)
<br /> Q 94) Ii I am d WOO W 0nl8y peneralor,I"F'4y that f have a ryrogran,In p1aCu tv!educe IMal cutrrvml avadaaltolld e to"a a wh"h I}09 WAVAQ Illimkrs tee proAtpd to the (ono land 6dure 1 tyu Ify81 to hwild to 04 aGt�e and
<br /> prectl cable 8nd thein htwn aetaetucl the pracll cable met"it Of traatm.inl,sta,ago,or dtepot: Y
<br /> the enVlfanment;OG li 1 am am711 quenlHy Qanafnluy.I h?Ve made A goad iaWr ONad to rnintmise my weals genmmm ata aolact tl,e haat waeta mend{ivatent method QWi I{oyalleilf0
<br /> TO me trot i can atrom.
<br /> Date
<br /> Customer at 0 bate Driver Signattire
<br /> rle:rt r1m„nrr Narnr;t
<br />
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