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L <br /> k <br /> i 9 <br /> Id.Mau P:2F IS <br /> 'A <br /> 0 <br /> A L W WW.W 0 R L D 0 11 R F�C 0 <br /> 01 " I <br /> I F 0":U-,I,'A -0 U I A V E <br /> E -,-)U!SE AVE <br /> Z.0550 AVE EPA CA00282770,36 50 L <br /> L.A I T I-+ OR, -APu 330 <br /> %...A77-HROP,—A9"` 0 <br /> M -58 <br /> 8 -4110 <br /> GUSTONIER# PURCHASE OREFER—# ROUTE# TRUCK# i "E_0_NTP6*7_"'NAME—I ORDEPTAKENSY HALIDES <br /> TEG605 <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE- CUSTOMER EPA# BILLClf'LADING/MANIFEST# <br /> 414 21-7Q19--- 4134)n 19-- C A_10-0-0 4 4 5 A a 0 <br /> PART# DESCRIPTION QTY UNIT PRICE;OTY P/U- TOTAL <br /> OF USED METAL C)iL AND GASOLINE FILTERS 2 $55-00 <br /> 01F*DR OIL FILTER DRUM REPLACEMENT NO.CHARGE 2 0.00 $0.00 <br /> aATC11 <br /> TOTAL <br /> CASH <br /> CASH REC'D:--- CHECK#._ 4 <br /> WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/M(XED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL sow*nONS) STATE CODE.---- <br /> OTHER: <br /> L P' DESIGNATED; <br /> AIMOU57WA5TE. LI EIR <br /> ALTaRN SAMANAGEPAJE <br /> ENT-1 <br /> tF els: A=0'unt Vvanagelr Sam Read <br /> DRUPA'W EMPTY DRUMS------- FACILITY,-_. <br /> GENERATOR WASTE CERTIFICATION (PLEASE CHECK THE APPROPRIATE BOX) <br /> By signing't.otow I herci)y certify that, <br /> (Waste oil generator/customer MUST check ONE of the following three boxes) <br /> 11)1 have not tabled any of the wase aescribod above with eny other liaznro-nus waste,vm!ota,.imiiiao Qomcnl it,i.%*ss tv,,;o imo ppm.and tho warlmdries not contain any PCs,,.I have <br /> r <br /> compiled with the requirements of the applicible California used oil mariagement regtdations to dctenliirt,.-this is;rvo.I agr,�,c to accept tile additional charges for tile r!jG.')..!;at of title jV34'tU if <br /> the*Information I have provided about this waste is Incorrect <br /> U- 92 1 havo no2 fifted any of the wasto described above with ally otior tiazardous voesic-,isio tonli..,n!ide corawn:!A.CV-ir_'AI'Fil wokn-1:11100 ppm,and the vio!;m 00LIS Mot contain nm PCi3r..i <br /> have provided proper documontation to World Oil Environnianull services.',c ecuu!!lie wct:utl)Wion lh-Ut7a miixca-.Ath oillor hazardou!-v,,,iTto.i;inri:o to zccopl,the !dditI0'-l43! <br /> charges for the disposm 0i this wasto If the information I have provide-ii ni)oul tilts ve---stc is incol 1'-'Ct <br /> �-13)-nlis vmsl"1'�fronin tank-winCh colklc!swast�,oil from !-­k nt::, <br /> i . I . Wtit' .*o th.. <br /> kmovil&,Vc.lh�.-only Y.a-ztc oil crintwrted In my DIW Cf-:SQG coj;cczon 1ziii.is ntlo-V f�om 17,1V Llr'i MINct!111vir,vale-tv':'4! 'Pel' oil <br /> front rther sources. w'1I*'_.r to lie nddltion;.*divirgtrc lop C!S'? ot v.­!-_-'e liti-'r- Toll.1 il'lvc hh: <br /> ;Afl) <br /> "rnf;i; n. <br /> 'hk <br /> ":n <br /> (Ca <br /> X <br /> V <br />