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r-oR SERViCE !.! . SERVICE ORDER <br /> PARLIER ASBURY ENVIRONMENTAL SERVICES. D-GA FORM NO.WOFS004-D (1/17) <br /> 559-4,98-0240 SERVICE ORDER NO. <br /> FOR ACCOUNTING CALL.,. <br /> 562-23i-1550' <br /> WORLD OIL <br /> E-N V 1 R 0 N-1 N1 FE'.N TA L S EE RA/i C-E- <br /> 14287 EAST MANNHNIG AVE,PARI-FIR CA 93648 <br /> 1-559.49P—Q240 <br /> it r P <br /> VVWW.WORLFj0'LCORF.COM <br /> T <br /> TRANSPORTER EPA#CAD028277036 <br /> CUSTOMER PURCHASE ORDER T--TROUTE,-17- Ti UCK t CONTACT NAME ORDER TAKEN BY HALIDES <br /> DATE REQUIRED DATF ENTERED NEXT SERVICE DATE CJS-OMER EPA BILL of LADINCVNIANIFEST4 <br /> b <br /> PART DESCRIPTION CITY UNJT PRICE QTY P/U TOTAL <br /> 4 <br /> TOTAL <br /> CHECK <br /> ,�--- <br /> WAS TE DSPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS IX6,STF,LIQUID,USED OIL/MIXED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WAST[,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE <br /> I OTHER- <br /> DESIGNATED TS DF: <br /> ------—- -------- <br /> A LTE R IN AT E TS D F: — <br /> DRUMS —-------- EN11PTY FACiUTY:-- <br /> GENERA70R'l/VASTE CERTIFICATION (PLEASE CHECK THE APPROPRIATE BOX) <br /> (WaSIO oi! -enerator/cijStoMer MUST check GIVE of the following three boxes) <br /> tT tLtal hah&conteat il Lc:,S 11hal,107x7 ppm,and the'=caste does not rorltaVl any PC85.I hdVeCQMPH0d with the regpiremenCs of <br /> thQappkar'!'c4f""'ia us-2duii management <br /> 0cjfee D."'2pt the additional 0�'g-y lo'rF--dlsnosal Lf lhiL waste if the infDrmatio❑I have provided about this waste f5 incorrect <br /> F::::1#2 1 lave not mixed I-v o',the was'e'-s' 'TFq than I,P.10 ljprnr and Nle waste does not Contain any PCBs-I <br /> 'la�mixed with oilier rja�ardou5 waste.i agree m Bocept the 00ditiorill charges for the dispQs3f of this <br /> wrisZp it the mformotion I have provided arv <br /> -1 Lot lc do roes.To The heel o(roknowledge,the only waste oil contained <br /> ":pith;lni )the 1-=rd- 5tc ciltcn,EYthtar.sourc&.5.f pgreero accept the additional charges fir disposal <br /> (All geT- <br /> d the following text and check the associated box.) <br /> "nnerat=d to Zhk�degree f have, to he PropomicallyPiacpracticable and that;have <br /> L- ri2v'111,zes kl-'e P;asrrntznCl mw,,.,zhieat zo hilmar lilz and ihr-enviroiimer-T,D,if I am.a small quawitygene,alor,I <br /> hale—de a g nod Jic: L' -:!M! -aciemeil(method that is ataOable ic ord. <br /> T <br /> This mai,id.akepgr inn in the space ser f,-,,rh be!oa on b2haR of �.nj,chat has rhe a.thn'ify i;ac the forgoing d-criprioni 01'wasle and matenafs are True and accurate <br /> a,packaged,:narkd and labeled,e.re;eady to.no,%perat;oi L in aC twdarlce W'Ln ei;pkj, --lie and federal reguEauor,.snrl chat Cuswrnei mdJJ abide and bobDund by the,Standard Terms and Cqndirions on the reverse <br /> `s"d-of this <br /> -7 <br /> CustornerljSignature Date <br /> Driver Signatu,v� y Date <br /> Pr nt Name Print-DLvefs Name <br />