COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

FOR-SERVICE CALL: SERVICE ORDER FORM NO.WOES004-B(8/181, DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA 1-800-727-2879 SERVICE ORDER NO. N2801153 FOR 562-231-1550NTING CALL: WORLD OIL ENVIRONMENTAL SERVICESW TEC OF CALIFORNIA-LOUISE AVE 7300 CHEVRON WAY,DIXON,CA 95620 1-800-727-!2879 P' 2050 E LOUISE AVE 2050 F LOUISE AVE P WWW.WORLDOILCORP.COM ° LATHROP,CA 95330 TRANSPORTER EPA#CAD028277036 LATHROP, CA 95330 o (209)858-4110 (209)858-4110 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN OY HALIDES 9 r - DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# MPT#' 114B 9ASBUNE Q UNt E •°QTY P/U T ETERG --T OFDR OIL FILTER DRUM REPLACEMENT-NO CHARGE 4 $0.00 - � X0.00 .BATCH, ,. TOTAL CASH:R.E013: CHECK i� WASTE DISPOSAL INFORMATION N4N111161RA HAZARAOUS WASTE,LIQUID.(USED OIL/MIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUSV-ASTE,LIQUID 4ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: NQR--RCRA hUAPDous ZME-fiQLIn(FILTERS=MMM-0- . A-EE=-DE-223..-...,_._. DESIGNATED TSDF: YBSr AI+U EMENT,INC.,I51113 US HIGHWAY 95,YUI'iciA,AZ 05365,928-344-962.B _ -----� ALTERNATE TSDF: Cross Account Managw.Sam Read DRUMS PIU.: 50 EMPTY-DRUMS: FACILITY: BSC GENERATOR-WASTE'CERTIFIGATION (PLEASE CHECK THE APPROPRIATE BOX) By signing below t harebycortify that: (Waste oil generator/customer MUST cheer ONE of the following three boxes) 0 61)1 have not mixod any of the waste described above with any othor,hazardous wast6,the total halide contont Is LFSS than 1,000 pprn,and the waste does not contain-any PCBs.I have compiled with the requirements of the applicable California used ell rnaitagement regulations to detertnino this is true.I agree to accept the additlortil charges for the disposal of this waste if the Information I have provided about this waste is Incorrect.. 0 112 have not mixed any of the waste described above with any other hazardous waste,the total halide content Is GREATER than 2,000 ppm,and the waste does not contain any PCBs.I have provided proper documentation to World Oil Environmental Services to rebut the presumption that this waste was mixcd,with other hazardous waste.I agree to accept the additional charges for the disposal of this waste If the information t have provided about this waste Is incorrect D 03)This waste Is from a tank which collects waste obi from household"do•it-yourself"(DlY)ancYar conditionnitl excerpt cm:;li ctuanuty,generator(cnaG)sources.To the best of my knowledge,the only waste oil contained In my DIY/CESOG collection tants Is soloy front DIY and/or CESOG soueces.I hnve not mixed this tiraste rail with cny other hazardous waste or waste oil from other sources.I agree to accept th6 additional charges for disposal of this waste If the information I have p-tovided ab.--vt thisv .asty is incorrect (Ali generators/customers PAUST red-the f0ff1a441I1g text I certify that I have a program In place to reduce the volume and toxicity of waste genornted to tint:eie mn I l:nv cynic^;;iii..-c'iv ter-•ec*iwtreicrity rrtacticawe and that I have soiected the practicable method of treatment,storage,or dispoael currently available to me which mirlm!:es the pm,,L+let incl r,el:u*a!hr::Eli to hm"I:m 111C r:n::trio of:viron:l en!. This Individual signing in tha space set forth below on behalf of customer represents and warrants ties;hv-?sie:!hr::u-,e nu;horky io Maxi ceesi;;ma;,ihAt the forgoing descriptions of waste, and materials are true and accurate as packaged,marked,and labeled,are ready for tray snortation fat accord.-.o.c:�:iti:a::+(:ilei i=�:_sic�tc:s:Ild f eda m$reou'aVons..and that custonmr shail::bidn by the Standard Terms and Conditions on the reverse side of this Servico Order. Service Orders with an Associated hazardutts waste manifest(either site specific or conzcli:+Fitt:d'.:cae:cL"t�:i :.'i SC.::1!_i':t:y::�, The:sir if:sF£eivo 4:tL'EPr.i:P.ea;a-ti?:O(J jil feSS:aiwi SfteiSle:i::lrastittjy ci the eVanifest program. 7110ee fees vary based on Manifest type. Applicable torts wHI vp�peis on;+ :�t:?blocs aWVC—i(:c>. ---.� Cu (UI? e-r Signature Dal 9 r