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To: From: DDS 40 Sat 21 Nov 1992 19:47:56 Page: 10 D <br /> - '- ERVICE oltD' R <br /> No. N. 240911 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH A]I AMEDA STREET ❑ COMPTON, CALIFORNIA 90222 ❑ (310) 886-3400 <br /> SAN DIEGO Off ICE NORTHERN OFFICE <br /> 1-800-748-57 4 EPA NO.CAD028277036 1-800-727-2879 <br /> 1-800-933-9194 <br /> DATE t•, ti ONE TIME PICK UP © YES or 0 NO <br /> CUSTOMER a; ; { `: >, + RESIDENT ❑ YES or ❑ NO <br /> BILLING ADDRESS �'•�. i 1 : .`r CONTRACT CUSTOMER 11YES or E3 NO <br /> PHONE Y h "7` '/_ -1 ,/ i CONTACT ACCOUNT NUMBER <br /> CUSTOMER EPA N AMOUNT y <br /> JOB SITE ADDRESS _ � � CHECK NUMBER <br /> P.O. NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> NOTES., COMMODITY <br /> -' r7 �/ _ �.�` ��..• HALIDES RPM, <br /> Cf COMBUSTIBLE LIQUID,N.O.S.(U ED OILS MIXED OILS) <br /> NA 1993, PG III <br /> ❑ ETHYLENE GLYCOL NDN-RCRA <br /> HAZARDOUS WASTE LIQUID NO PLACARD REQUIRED NEXT SERVICE DATE <br /> ❑ U.S. DOT DESCRIPTION: DRUMS <br /> MANIFEST NO,. r _ - NO,OF GALLONS <br /> DRIVER, 47t TRUCK NO. &RT <br /> i <br /> DESIGNATED TSI)F: U ALVISO'INQEPENDFNT OIL• 5002 Archer St. -Alviso, CA 95002 <br /> ❑ BAYS1D OIL 11,INC. -210 Encinal St. -Santa Cruz, CA 95060 <br /> ❑ 8C STO KING-7300 Chevron Way- Dixon, CA 95620 <br /> Q DcMEN�OIKERDOON- 2000 N.Alameda St.-Compton, CA 90222 <br /> ❑ OCS - 3256 N. Marks St, - Fresno, CA 93722 <br /> RAMOS ENVIRONMENTAL • 1615 S• River Road •W, Sacramento, CA 55691 <br /> This is to certify that the above named articles are proparly classified, described, packaged, <br /> marked and IaWed,and aro In proper condition for transportation,according to the applicable <br /> regulations of the Department of Transportation_ <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED x <br /> THIS WASTE WITH ANY OTHER WASTE,AND THE <br /> TOTAL HALIDES ARE LESS THAN I ow P.P.M. CUSTOMER SIGNATURE DATrz <br /> I FURTHER AGREE TO ACCEPT THE ADDITIONAL <br /> CHARGES FOR LEGAL DISPOSAL IF THIS WASTE <br /> vauT A)nAl� <br />