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4C-03-08 13:37 From— K Dizr 17076782339 T-445 P.006/009 F-886 <br /> - SERVICE ORDER <br /> 0 WE <br /> bft No. N X626756 <br /> ASBURY ENVIRONMENTAL SERVICES 3400 <br /> 1300 S.SANTA FE AVENUE Ll COMPTON,CALIFORNIA 90221 0 (310 88(1ERN CALIFORNIA <br /> SAN DIEGO O FICE 1-800-727-2879 <br /> 1-800-748-57 4 EPA CAp02(3277036 <br /> } ONE TIME PICK UP El YES or Q NO <br /> C. <br /> DATE <br /> f RE51C)ENCE O YES or E:1 NO <br /> CUSTOMER <br /> CONTRACT CUSTOMER O YES or ❑ NO <br /> BILLING ADDRESS <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER , <br /> CUVOMER NUMBER j'li)(.', "•! <br /> PHONE i ' 1,' l: 1. s CONTACT <br /> AMOUNT <br /> CUSTOMER EPA rt <br /> I <br /> CHECK NUMBER <br /> JOB SITE APDRE~SS � <br /> 4' PO.'VUMBER <br /> CASH RECEIVED - <br /> CROSS STREETS (AMOUNT) <br /> CwMODITY 1L)1� <br /> NOTES: HALIDES,It \L -�PM, <br /> EX NON-RCR .HAZARDOUS WASTE,LIQUID(USED O"IXED OILS)STATE CODE 221 <br /> NO PLACARDS REQUIRED" 133 <br /> [INON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)51ATE CODE NEaT SERVICE DATE <br /> .NO PLACARDS OR MARKINGS pEQUIRED" DRUMS DRUM SIZE <br /> ❑ OTHER 7 L� <br /> rl ' f N0.OF GAU_ONS ) <br /> MANIFEST NO. 1 <br /> ,' !7 TRUCK NO.&FIT <br /> DRIVE=R ° -�,.[. <br /> d NON HAZARDOUS DRAINED ED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYali NG,33210 Western Avenue,Union City,CA,510-487-8277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF: GI ALVISO INDEPENDENT OIL-5002 Archer Street•Alvlso,CA 95502•CALOOD161743. (510)476-1740 <br /> E-1 pAYSIDE OIL II,INC.•210 EnCinal Street-Santa Cru=,CA 95060•CAD088835222-(4 08)427-;1778 <br /> EDEVERGREEN ENV.•4139 N.Valentine Ave. .Fresno,CA 93721•CA0982446882 (510)7115 400 <br /> [2 DEMENNO/KERDOON •2000 N.Alameda Street•Campton,CA 90222-CAT08001335 2-(310)537.7100 <br /> E)(WK DIXON•7300 Chevron Way•Dixon,CA 85620.CAT080012602•(707)693 6008 <br /> p ASBUAY ENVIRONMENTAL SERVICES <br /> z54�9dscott Avenue nto,CA chlCo,ca 5592e C91. Aulo 827s4q(916)371-5747 <br /> ❑ ALT'ERNAXF FACILITY <br /> USED oIL USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE Thle is to ceRlty tra,the above named articles are propOrly ciassnied, described,packaged,mark <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERPOON THE and labored,and arq in propefaonditlon for transportation,according to the applicable gulatlona <br /> LARGEST RECYCL-ER OF USED OIL IN THE WESTERN UNITED STATES, the Deparimint of Transporm On, <br /> "1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 RRM.: X cu5 M IGNATURtS DATE <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.13'S.. l <br /> 11 FURTHER AGFIEE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL x <br /> DISPOSAL IF THIS WASTE IS OVER lod0 P.P.M.TOTAL HALIDES, OR p'NTN4M <br /> r-nAITAINS ANY PC,B'S. <br />