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FOR SERVICE CALL: <br />PARLIE13 <br />559-498-0240 WO <br />FOR ACCOUNTING CALL: WODIY <br />562-231-7550 <br />AF <br />PEP BOYS #107i 1 <br />4987 WEST LANE <br />T STOCKTON,GA 95210 <br />D (209) 952-1222 <br />ASBURY ENVIRONMENTAL SERVICES, DBA <br />0 L <br />^I 9rtl40 <br />wW W. WORLDOILCORP.COM <br />TRANSPORTER EPA# CAD028277036 <br />FORM NO, WOES004-D (1/17) <br />SERVICE ORDER NO, <br />N2570748 <br />THE EG GROUP <br />201 E. ORCHARD ST <br />HAMMONTON, NJ 08037 <br />(800)334-3794 <br />CUSTOMER# <br />CttNtRA I UH WAS TE CERTIFICATION (PLEASE CHECK THE APPROPRIATE BOX) <br />By <br />PURCHASE ORDER# <br />ROUTE# <br />TRUCK# <br />CONTACT NAME <br />ORDERTAKENBY <br />HALIDES <br />PEP359 <br />ER -86 <br />SCHEDULED -I <br />DATE REQUIRED <br />DATE ENTERED <br />NEXT SE VICE DATE <br />CUSTOMER EPA <br />BILL of LADING/MANIFEST# <br />5/10/2018 <br />5/3/2018 <br />CAD981662844 <br />PART# <br />DESCRIPTION <br />QTY <br />UNITPRICE <br />QTYP/U <br />TOTAL <br />OFDR <br />OF <br />BATCH: <br />Cro <br />CASH RECD: <br />5s <br />OIL,FILTER DRUM REPLACEMENT- NO CHARGE <br />USED METAL OIL AND GASOLINE FILTERS <br />Streets: <br />CHECK #. Accaunt'Manager, <br />1 <br />1 <br />Steve Gately <br />_r <br />TOTAL <br />1 " WW <br />WASTE DISPOSAL INFORMATION <br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIL/MIXED OILS) <br />NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) <br />OTHER: NON-RORA HA7ARDnLIC NtAST�_SOI I��/FII TFRS I:C TA)flgNC� OII) LATE (:CinF 774 <br />DESIGNATEDTSDF:_YUMAAT$-H: IDI6f—MTH.8T_IMA A 85385_52&86k28 <br />ALTERNATETSDF: <br />STATE CODE 221 <br />STATE CODE_ <br />- <br />DRUMSP/U: <br />EMPTY DRUMS:__ FACILITY: <br />BSC <br />signing below i hmehy certify that: <br />(Waste oil generator/customer MU57 check ONE of the following three boxes) <br />Oat) I have not mixed tory of the wasted <br />above with anyother harallous waste, the total halide contentlz tC55 than i,go0 ppm,and thewaste does not contain any PCas.l havecomplled veldt the requirements of <br />the appllable California used of management regulations to determine this Is true.I agree to accept the additional charges for the disposal of this waste inhe information I have provided about this waste is Inmrrecs <br />=192 I have not mixed any ofthe waste described above with any other hazardous waste, the total halid¢ content is GREATER than 1,000 ppm, and the waste does notmntaln any PCIIs. i <br />have provided proper documentation to World DII Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste. i agree to acceptthe additional charges for the disposal of this <br />waste if the in(orma[ionlhave provided about thiswazte is incorrect <br />L_7N3)This waste is from a tank which collects waste oil from household 'do-it-yourselP(DIV) and/or conditionally exempt smaliquantity genentor(CESQG) sources To the best of my knowledge the only Waste od contained <br />In my DIY/CESQG collection tank IS coley from DIY and/or CESDGsources. l have not mixed This waste oil with any other hazallous waste or waste oil from other sources.) agre <br />e to accept the additional charges (orduposai <br />of This waste if [M1e information I have provided about thtz vraste is Incorrect <br />(All generators/ customers MUST read the following text and check the associated box,) <br />f I aon a large quantity generator, I certify that I have a program 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 />ected the practicable method of treatment, storage, or disposal currently available to mewhlch minimizes the present and future threat to human life and the environment; Or, if lam a small quantity generator, I <br />have made a good faith effort to minimize my waste generation and select the best waste management method that is available tome that Ind afford. <br />This Individual signing in the space set forth below on behalfol'Customer represents and warrants that he/she has theauthorityto bind Customer, that the forgoing descriptions of wasteand materials are true and accurate <br />as packaged, marked and labeled, are ready for tmnsportatien In accordance with applicable state and federal regulations, and that Customer shall abide and be bound byline 5tandaNTerms and conditions on the r <br />side of this Service Order. e <br />Cush. er Signature Dale � .� DriverSignature _ at <br />Print Name Print Drivers Name <br />