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SERVItt ORDER <br /> r <br /> NO. N 332147 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH A MEDA STREET ❑. COMPTON, CALIFORNIA 90222 0 (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN OFFICE"; <br /> 1-800-748-574 EPA NO.CAD028277036 _ 1-800-727-2879 <br /> 1-800-933-9194 <br /> DATE ` 7 ONE TIME PICK UP ❑ YES or NO <br /> r <br /> j <br /> CUSTOMER /F.� f r RESIDENT ❑ YES or D NO <br /> � l9•r•+4 !•`� � �.� <br /> BILLING ADDRESS ` CONTRACT CUSTOMER -0 YES or^❑ NO <br /> PHOZZI'V Y 7 S CONTACT ACCOUNT NUMBER <br /> - I <br /> CUSTOMER EPA N AMOUNT <br /> JOB SITE ADDRESS r .•� > CHECK NUMBER <br /> P.O. NUMBER, <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUIM <br /> NOTES: COMMODITYf'r"�f <br /> HALIDES P.P.M. <br /> } <br /> J NON RCRA HAZARDOUS WASTE LIQUI)(Used Oils/Mixed Oils)NO PLACARD REQUIRED . <br /> NON RCRA HAZARDOUS WASTE LIQUI ,CALIFORNIA REGULATED WASTE ONLY <br /> (Glycol&Water)NO PLACARDS REQUI RED NEXT SERVICE DATE 4 <br /> 7 <br /> OTHER /DRUMS DRUM SIZE _�: r.✓�` <br /> _. — . <br /> r NIFEST NO. NO.OF GALLONS <br /> IVER <br /> TRUCK NO.'&RT. ,� f <br /> NON HAZARDOUS DRAINED USED FIL RS - <br /> J <br /> �I t <br /> DESIGNATED TSDF: ElALVISO INDEPENDENT OIL-5002 Archer St,-Alviso,CA 95002 <br /> ❑ BAYSIDE OIL II,INC.-210 Encinal St—Santa Cruz,CA 95060 <br /> ❑ OTHER FACILITY <br /> ❑ DeMENNQ/KERDOON-2000 N.Alameda St--Compton,CA 90222 <br /> ®- <br /> OCS­3253 N.Marks St—Fresno,CA 93722 <br /> ❑ RAMOS ENVIRONMENTAL-1515 S.River Road—W.Sacramento,CA 95691 <br /> This is to certify that the above named articles are properly classified, described, packaged, <br /> marked and labeled,and are 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 <br /> THIS WASTE WITH ANY OTHER WA ,AND THE';.' <br /> TOTAL HALIDES ARS LESS THAN 100 P.P.M. CUSTOMER SI t�{MRE DATE <br /> I FURTHER AGREE TO ACCEPT THE ADDITIONAL <br /> X <br /> CHARGES FOR LEGAL DISPOSAL IF THIS WASTE <br /> AS OVER 1000 P.P.M.TOTAL HALIDES N NAME <br /> I <br />