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ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES002-D (1/17) <br /> FOR SERVICE CALL,: <br /> PARLIER SERVICE ORDER <br /> 559-498-0240 0 <br /> FOR ACCOUNTING CALL: N O• 1Y w� ' <br /> 562-231-1550 WORLD OIL <br /> ENVIRONMENTAL SERVICES•: <br /> 14287 EAST MANNING AVE ❑ PARLIER,CALIFORNIA 93648 ❑ (559)498-0240 <br /> EPA#CAD028277036 <br /> DATE CUSTOMER NUMBER <br /> CUSTOMER AMOUNT <br /> PHONE CONTACT CHECK NUMBER <br /> CUSTOMER EPA# P.O.NUMBER <br /> JOB SITE ADDRESS CASH RECEIVED <br /> (AMOUNT) <br /> COMMODITY <br /> CROSS STREETS HALIDES P.P.M. <br /> NOTES: <br /> SON-RCRA HAZARDOUS WASTE, LIQUID(USED OILJMIXED OILS)STATE CODE 221 <br /> 10 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 TRUCK NO.&RT. <br /> ❑ USED OIL AND GASOLINE FILTERS <br /> ❑ BIG SKY ENTERPRISES, 401 West Channel Rd., Benicia,CA 94510 CAL 000301639 1-510-541-2128 <br /> ❑ GLOBAL MATERIAL MANAGEMENT, 1640 N.Broadway Ave.,Stockton,CA 95205 CAL 000417315 1-818-770-2577 <br /> ❑ SA RECYCLING, 33210 Western Avenue,Union City,CA 94587 1-510-487-9277 <br /> ❑ YUMA YES LLC, 2730 E. 13th Street,Yuma,AZ 85365 AZR000515924 1-928-643-8938 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF: ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scot Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-CHICO II,LLC• 161 B W.5th St.,Chico,CA 95928•CAD980694103•(800)733-9043 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr., Fortuna,CA 95540•CAL920256136•(800)733-9043 <br /> ❑ BAKERSFIELD TRANSFER INC. • 1620 E.Brundage Ln.•Bakersfield,CA 93307•CAL000282598•(661)377-0308 <br /> ❑ D/K DIXON•7300 Chevron Way+ Dixon,CA 95620•CAT080012602•(707)693-6008 <br /> ❑ DEMENNO/KERDOON+2000 N.Alameda Street•Compton,CA 90222•CATOBOO13352•(310)537-7100 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave.•Fresno,CA 93722•CAD982446882•(510)795-4400 <br /> ❑ RAMOS ENVIRONMENTAL•1515 S. River Road•W.Sacramento,CA 95691 •CAD044003556•(916)371-5747 <br /> ❑ WORLD OIL-SAN JOAQUIN,LLC• 14287 E.Manning Ave.•Parlier,CA 93648•CAL000102751 •(559)498-0240 <br /> ❑ ALTERNATE FACILITY <br /> i -)IL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named articles are properly classified, described, packaged, marked <br /> Ri LED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are in proper condition for transportation,according to the applicable regulations of <br /> LAII'iiiiii RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <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.Pi X ' <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DATE <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY P.C.i PRINT NAME <br />