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r-oR s�Ftvlct: ca��: <br />RARLIER <br />559-498-0240 <br />FOR ACCOUNTING CALL: <br />562-231-7550 <br />\� <br />�� <br />PEP BOYS #0711 <br />4987 WEST LANE <br />lr I L.. I-p� <br />( �U <br />o STbCKTbN,CA 95?_10 <br />b (zos) s�z-lzzz <br />ASBURY ENVIRONMENTAL SERVICES, DBA <br />o <br />. f •� <br />W W W W ORLDOILCORP.COM <br />TRANSPORTER EPA # CAD028277036 <br />FORM NO. WOESU04•D (1117) <br />SERVICE ORDER NO. <br />Nz603853 <br />THE EC CROUP <br />201 E. ORCHARD ST <br />HAMMONTON, NJ 08037 <br />(son) 334.37sa <br />CUSTOMER# <br />PURCHASE ORDER# <br />ROUTE# <br />TRUCK# <br />CONTACI'NAME, <br />ORDER TAKEN BY <br />HALIDES <br />DATE REQUIRED <br />DATE ENTERED <br />Bl27 018 <br />NEXT SERVICE DATE <br />CUSTOMER EPA# <br />CAD981862844 <br />BILL of LADINGJMANIFEST# <br />'� <br />PART -0f <br />DESCRIPTION <br />QTY <br />UNITPRICE <br />QT/YP/U <br />TOTAL <br />WO <br />BATCH <br />Effective 7/ <br />thrqugh fee <br />USED OIL/ MIXED OILS <br />i <br />1201 E3: Service grders with associated hazwasta manifests (site speaific/cnnsolida <br />and adminlstraflon of the eManitesk prggram. Fees vary tram $4 - $10 based qn M <br />30 <br />ad) are subJec <br />nlfest type, , <br />tq an EPA Fee, <br />plleable fees wit <br />/ <br />ees agver <br />a���on <br />/p <br />pA pose- <br />Aur indgice. <br />CASHREC'D: CHECK# <br />WASTE DISPOSAL INFORMATION <br />NON-RCRA HAZARDOUS WAS'iE, LIQUID (USED OIUMIXED OILS) STATE CODE 221 <br />NON-RCRA FIAZARDOUS WASTE, LIQUID (ETHYLENE. GLYCOL SOLUTIONS) � � STATE CODE .. <br />OTHER: AS@Util' E-NifIR9pFpgENTA!_ gERVlg�fi.gcpR `��M9R6RN R9�ERE„� z�rr”S^r55&f26$)S$#-#9P5,z,P,E99039:18fI0 <br />gDLErSIGNATEDTSDF: _ <br />C:foRSSA�a�tTreB�S:� - � t-ManSg�add�Aurit-- <br />DRUMS P/U:_ EMPTY DRUMS: FACILITY: BSC <br />C�tNtRAIOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE BOX) <br />by signing below I here by cer ti (y that: <br />(Waste oil generator/customer MUST check ONE of the following three boxes) <br />�lll I have notmixedanyof the waste described above with anyother hazardous waste, thetotai halide cement is LESS than t,oao ppm, and ihewaste does not contain any PCds.l have compiledwith the requiremenlsof <br />(r Iheapplicable California used oli managementregulatlo�ssro determine this is vue.l ayreeto a<<ep[the additional charges(or[hedlsposal of this wasteit the lnfmmationlhaveprovlded about this waste is incorrect <br />Op21 have not mixed anYofthe waste described above with anyotherhazallous waste, the total halidecontent is GREATER than 1,000 ppm, and thewas[e does not contain any PCBs.I <br />have provided proper documentallon to world Dil Envlronmenul5ervices io rebut dse presumption Ifiatthls vrartewas mixed wish other hazvdous waste.) agree to accept theadditlonal charges forthedlsposal of this <br />wazte ifthe inrmmallonlhave provided abou[Ihiswaste is incorrect <br />OM3)This w.ute Is from atankwhlch collects Waste oil from household'do-i[-yourself (DIY) and/prcondltionallyexerapt small yvan[ity generator (CESQ6) svurtes.To the bestof my knowledge, the onlywaste oil conbined <br />n my DIY/CESQG <oilecvon tank is Soley tram DIYanJ/or CESDG sources.) have not mixed thisvraste oil with any other hazardous waste orwaste oil tram other sources.lnyree to accept theaddillanatchazyes for disposal <br />otthis wasteit the Information I have provided about thisvraste Is incorrect <br />(All generators/ customers MUST read the following text and checkthe associated box:) <br />4) If I oma targe goantitygenerator, I certify that I have a program in place to reduce thevolume and toxicity o(wastegenera[ed tothe degree I have determined to heeconomi�itypracticabe and that have <br />selected the practlzable methedut Imalmenh storage, or dlryosal currehdy available to mewhich minimizes the present and future threattohuman Ilfe and the envimnmenCOr, ifi am a small quantity generator I <br />have made a goad faith effort to minimize my wazte yenemtion and select the best waste managementmethod chat is available to me [hatian afford. <br />on behahoFCustomerrepresents and warrants Ihat <br />Name - Print <br />inaterlals are vucandazcuzate <br />and Condliioiu on the reverse <br />7, �, <br />page <br />