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FOR SERVICE CALL: <br />PARLIER <br />659-498-0240 WO <br />FOR ACCOUNTING CALL: WODIY <br />562-231-1550 <br />AF <br />PEP 60YS #0711 <br />4987 WEST LANE <br />STOCKiON,CA 95210 <br />(209) 9524222 <br />SERVICE ORDER <br />ASBURY ENVIRONMENTAL SERVICES, DBA <br />ENVIRONMENTAL SERVICESm. <br />14287 EAST MANNING AVE, PARLIER CA 93648 <br />1-559-498-0240 <br />W W W. WORLDOILCORP.COM <br />TRANSPORTER EPA #CAD028277036 <br />FORM N0, WOES004-D (1/17) <br />SERVICE ORDER N0, <br />N237=1 <br />THE EC GRQUP <br />20t E. ORCHARD ST <br />HAMMONTON1 NJ 08037 <br />0)334-3794 <br />CUSTOMER # <br />PURCHASE ORDER # <br />ROUTE # <br />TRUCK # <br />CONTACT NAME <br />ORDER TAKEN BY <br />HALIDES <br />PEP359 <br />124yom <br />CHEDULED-! <br />DATE REQUIRED <br />DATE ENTERED <br />NEXT SERVICE DATE <br />CUSTOMER EPA # <br />BILLof LADING/MANIFEST # <br />5/23/2017 <br />5/23/2017 <br />CAD981862844 <br />DESCRIPTION <br />QTY <br />UNITPRICE <br />QTYP/U <br />TOTAL <br />rPART <br />BATCH # <br />Crus <br />USED OIL SERVICE CHARGEUSED OIL/ MIXED OILS <br />Streets: <br />�" <br />5CD <br />TOTAL <br />✓� <br />CASHREC'D: CHECK# <br />WASTE DISPOSAL INFORMATION <br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS) <br />NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) <br />OTHER: <br />STATE CODE 221 _ <br />STATE CODE._ <br />X <br />DESIGNATEURY-EFNIRONMENTAL-SERA <br />ALTERNATE TSDF: TSDF: <br />925��P'ta BQ3g <br />DRUMS P/U: EMPTY DRUMS:- - FACILITY: <br />BSC <br />GENERATOR WASTE CERTIFICATION (PLEASE CHECI<THE APPROPRIATE BOX) <br />Ry signing below I hereby certl(y Thal: <br />(Waste oil generator/customer MUST check ONE of the following three boxes) <br />791)have not mixed any of the waste <br />to y otherhaxard Lots]agretoacchalide content Is charthan1,0011ppm,andthew waste <br />Incontainanyave provided <br />Incorrect of <br />appiicabie CaR(ania used all management mgulatlans to determine this Is Vue.l agree to accept the additional charges for the disposal oflhls waste lithe Information i have provided abautihis wazre is Incorrect <br />D42 have mumixed any of the wastedescrlbed above with any other hazardous waste, the total halide content Is GREATER than 1,000ppm,and the waste does notcontaih any PCf s.I <br />haveprovided proper documentation to World Olt Environmental Services to rebutthe presumption that this waste wasmixed with o(herhazardous waste.) agree toaccgpl the additional charges forthe disposal ofthis <br />waste if flu intermation l have provided about this wasters incorrect <br />743)This waste Is from a tankwhlch collects waste oil from household'do-It-yaurselP(DIY) and/or conditionally exempt smattleentity genwater(CESQ0 samces.To the best ninny l:nmviedge, the mlywaste di contained <br />n my Dly/CESQG collection tankis soley Fom Dlyand/or CE51115sources.I have notm4xed thlswas[e all wllh any other hazardous waste orwaste oil from othersources.I agree to accept the additional charges fordisposet <br />of this waste if the information l have provided about this waste is incorrect - - <br />/ (All generators/ customers MUST read the following text and check the associated box.) <br />Sri) Ill am a large quantity generator, Icertify that) have aprogram in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that have <br />)acted the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human life and the envlranment,Or, If I am a small quantity generator, I <br />Ila ade a good faith effort to minimize my waste generation and select the bestarmte management method that is available to me that l an afford. - <br />This individual signing in the space set forth below on behalf of Customer represents and warrants that he/she has the authority m bind Customer, that the fmgoing descriptions oniane and materials ate true and actuate <br />as p dodge d, marked and labeled, are ready for transportation In accordance with applicable state and federal regulations, and that Customer shall abide and be bound by the Standard Terms and Conditions an the reverse <br />ride of this Service Order. <br />�ustorner ature Date DTIV Signature Date <br />rinf Nemo Print nrivarc Nama V <br />