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V. <br /> FOR SERVICE CALT-7 W", <br /> -NTAL SERVICES. DBA <br /> DIXON OFFICEE A S i,] <br /> I SERViCIEO RCEIR <br /> '1-800-727-2.879 <br /> 11\127722-95 <br /> FOR ACCO UI`r"i CW1 <br /> N'TING-i tAnLi-, low&%U%l 'pu <br /> 562-2311-1550 WIMIJ UIL <br /> _S <br /> 1V!C" <br /> 0'1Xf.)N,CA 9603110 <br /> ii tEC OFF CALIFORNIA-LOUISE-AVE <br /> 2 ZE_'R <br /> 2050 E LOUISE AVE <br /> F1 2050 E LOU)SE AVE <br /> P W"N'4'1.WORLD 01 L.GORP.COM <br /> E rRANSPORTER EPA CAD028277036 <br /> D LAT-MORCA 95330 LATHROP, CA 95330 <br /> T <br /> 0 (209)858-411110 (209)858-4110 <br /> CUSTOMER# PURCHASE ORDER ROUTE 4 TRUCK# CONTACT NAME ORDERTAKENBY - HALIDES <br /> BARRY ;8CME_btjtF!b__! <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# <br /> 9 CALUM 004154 <br /> -11/1/- i 11112019 7L <br /> MO—T# WJ0TjQN ,&?, 9WQT)�_ UN QTY P/U <br /> 194;�g ELF4L-T&RS <br /> OFDR OIL FILTER DRUM REPLACEMENT- NO CHARGE 4 $0.00 e- $0.00 <br /> BATCH 9 <br /> TOTAL <br /> CASH REC'D: CHECK <br /> WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILJMIXED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) '.!PTATE CODE. <br /> OTHER: NON-RCRA HAZARDOUS WASTE.SOLID(FILTERS CONTAINING OIL)STATE CODE 223 <br /> DESIGNATED g28-0 3 <br /> ALgERNATE TSDF.'.— -am <br /> toss eels: • Xceam manager Read <br /> DRUM$P/10 EMPTY DRUNIS:______.. FACILITY:__ BSG _ <br /> GENERATOR WASTE CERTiFICATION (PLEASE CHECK THE APPROPRIATE BOX) <br /> By signing below I hereby cariffy that: <br /> (Waste oil MUST check.ONE of the following three boxes) <br /> `-0 0111.1 have not mixed any of the waste described vivili anv olint--,-i1!;-Zudous viasto,t"Ite ta'al halide content is LESS than 1,000 ppm,and the waste does not contain p;ly PC8L.I lave <br /> complied with the requirements of the applicable catifomia used oil regulations to dote:mina this Is true.I agree to accopttho additional charges for thodispor-il of this:vasty if <br /> the Information I have provided about this viastc Is incorrcct <br /> 0 921 have not mixed.any of the waste described abbavovrlth any o-.i-,-.,. vivme:ti.e.0tal haNduconiatit Is GREATER than 1,000 ppm,and the waste does not contain any K13s.i <br /> have provided proper documentation to World Oil E:nViromilentai Sc: 10 i f.-bUt!!%; Uli'i U113 W-%S&O Was MIXOd With other hazardous wasto.I agree to accept the w,"ditio-iful <br /> charges for the disposal of this waste ill(ha informnuon I ituiis was!c nicorrect <br /> 'l] #3)This waste Is from c tank w!iici­, "'Inwc.0!:!fron" (F.:V"'Jldior c'.u!�,mion,>uy oxonii')t swali quantity gonat-stor(CFSQG,)sovrc-?:;.T6 til::I-vs'of my <br /> knowWgo,the only wasto oil"-attaised ill illy MY/CE"S'W; D;Y '-ndior sourcc:.I li,%*/;-ntA milxtd this waste oil vilfi,.any othcr haznrdous OR <br /> from other sourcea.i agree to accept tiic-vd(tiiiorin:c!v:.rsc,� r;!* if informnl1o;',�;*'_ <br /> i4 t:P;0'j'j0.j'1hoj!t ti <br /> ]i. <br /> W'(Ste iir incorrscl, <br /> f-Alovifing text <br /> I ccrtily that i imvo a vuqr?­.1 in :ace to rcdl.'U' 11-::;voivr-'f" tin., ha:?dolzri-nined ie;tu econonticn!ly prazt- ab!-t a.nd if nt I li%vu <br /> pni0icabItt mrtiiod of sarae!e'of fattire thrent.to liumian li"a tild'he environment. <br /> h;s indivIdual rannIng In 11'r-space-4,;.'iort."' zn n.r.41a, of r, tf*­!:. lips the euthorit-i wpc;�custonter,tim,tim-forvoini,dase-i.tiol o <br /> .0 <br /> its ale 1.ite and Z:s with •upplin"r-1-h;Slate and <br /> and materi., (C-derr.,Fc. clid <br /> b7 the StiMck"-d I*a,-".--'r.n.-.2-_�ondilom-.O.'n <br /> :6:.-c.,iil:t; <br /> the 11,1!1 1 'T"f; "wo!t <br /> 4�/y <br />