|
P�CALL: SERVICE ORDER IF NO.WOESW"(8/18)
<br /> DIXONO ASBURY ENVIRONMENTAL SERVICES, DBA =
<br /> FOR ACCOUNTING CALL: N3`1011110
<br /> 562.23,-,550 () WORLDOIL
<br /> ENVIRONMENTAL SERVICES,.
<br /> S 7300 CHEVRON WAY.DIXON,CA 95620
<br /> P XIKIilfitl1l�ti�+i�
<br /> E f 8+IV M t� tG WWW.W PLDOILCORP.COM 001�11~fiTlLS,
<br /> '� TRANSPORTER EPA#CA002SM036 -
<br /> TSTCA>Mff2 Q 02
<br /> CUSTOMER# PJRCH'A-ST ORDER# ROUTE# TRUCK CONTACT NAME ORDER IAMN RY ,9=
<br /> TOM GWAtNlRA'AJFL
<br /> r
<br /> DATE RBQL Sp IM!M ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL
<br /> PART*' . N QTY UldT PIN=
<br /> -.
<br /> 1�F=QyALLQN Cff MET 41_ :R 2% i W4 00
<br /> t`JLV* W EPP%Fi ?. :.CA'11i; Tl'! �'C��+l. (41�►9tIF� 1 y���
<br /> OKY Get Y WATER PEP W1 JW 00
<br /> _ TOTIA4., ' -
<br /> CASH REse±Ds CH1:CK
<br /> WASTE DISPMAW ATION
<br /> #
<br /> LIQUID OMED OILWX€D Ag.$)
<br /> •NOW4MAMWRlaOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE r
<br /> 0TWIt9
<br /> DRUMS FYU EMPTY DRUMS: FACXM.-
<br /> -1110MERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE
<br /> By alp"l*M Poway POWsA:
<br /> (Waste oil generator/customer MUST check ONE of tate following three 11tox10)`
<br /> 0tt}a tfsrW a�=of tffr WPW.depodrWf above with"COW hwWdOm w,ee,the tdd hallo so dwd is LESS tion 1,MPpm,end 00 Wawa,don doriot ambdo Nor kfmfr .
<br /> YaampWime-i
<br /> �+.ano ma j.tnw i se m �
<br /> , a vw admolw dot&$verSao
<br /> �c��als�iw�p►,l1
<br /> Q ttQ i tlwwpol athrtltnfy of iw,a.W.d,egl6pd abore wRh my olsor h wftus waw tate trAw he"@ cm"*la QREATER don JAM pPv�and the wastf[dawf so t '
<br /> hpre IH 9 Mad pew doia wf aftooff to wofad OU 6svtmrAMM 8ervtsea to tebW saw prestimpftm mat afalf waw we maxed wqh odrer tormdotm frla,M 1,�,,b pp
<br /> ch""for ow d poral of ode MOW E the rflornm*m l hem Provided abDw&"weal"is hicorfaet
<br /> dOf IaM,srasys it frw.a a,plt oil tram sfou,alfold oo-hyotfre,rr(ntv)anc4br aotWlMonaGyWKS
<br /> mpt sinal quW+dh O,nmflw(ctFMM taopram*16 ry
<br /> ,�Maultrripplwal[wa+f,rNd>n mtr t>E+q CEBW ooAactfon tent Is coley Atm M aodbr CWQQ eatroe,.1 h,vr not Mho,d tad,wmg%op WM arty otlf/il iMtaWs nM
<br /> t o ttdtr)tai>si cello addlpatri!alwryes tar dlstm,d of thaw wrMe No*inlonnaftn 1 tore provided donut o&w,q,1,rf "act
<br /> (All generators/customers MUST read the following text
<br /> 1 txMEatr twat[twsa proparp 1p pkiorlR ltidttoNh,t3ol M end tox"V of waw taelasraead to the dedr.l here dMermkod a be economically prpotlaepl,end VW 1 flev,,tileolld lhp
<br /> Pfaadoe0b tpptlaad of' olaniEp,Or dspeatl 0--ft watbbl,to me which mrdmtree Ufa WgWA and fuh"thwart W Wm=Rh&W on VMMMW*,
<br /> _ p f}11d1�IPw aft .Eff oupLM}Ipr Pt4(,eMlt,aid,MMin4 t w hdeh,hee the aufhgNty t0 band 6lI,IbNlM; ,t '
<br /> 1r-7m'40 01iW Riff" fd.' tlw� txwe�der. fOf man In scoord.na with eppgaote start road 1,1,
<br /> 0f>IMfM l plpgl,p Thi,Ifts MY 100W oh IlrfAl,etisyPe ApPlicaW,Ibe, ,m�ta,n EPA Fee. Thea ft"cover tlm EPA pe,WpouSA/e,orad !
<br /> aPPe+r an your m,xfto.
<br /> Cuswftwr 9lgr ftwe - Date -- Driver Sfgnuture Dade;
<br /> Print Harm,
<br /> Paint Driver Name
<br />
|