Laserfiche WebLink
w= -- -- SERVICE ORDER <br /> No. N 261376 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH ALAMEDA STREET ❑ COMPTON, CALIFORNIA 90222 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN OFFICE <br /> 1-800-748-5744 EPA NO CAD028277036 1-800-727-2879 <br /> 1-800-933-9194 <br /> DATE I - a i ONE TIME PICK UP ❑ YES or ❑ NO <br /> , <br /> CUSTOMER r J ! Ir:F r ;&t RESIDENT ❑ YES or ❑ NO <br /> BILLING ADDRESS j c 7 1 ~ 1 �1 -t N A CONTRACT CUSTOMER ❑ YES or © NO <br /> 7 <br /> PHONE r'f^ int} CONTACT ACCOUNT NUMBER <br /> CUSTOMER EPA M J _ AMOUNT <br /> JOB SITE ADDRESS J ,r' -- t i.* r ti _ CHECK NUMBER <br /> PO NUMBER <br /> OSS STREETS CASH RECEIVED <br /> (AMOUNT] <br /> NOTES COMMODITY { r} <br /> HALIDES P P M <br /> ❑ COMBUSTIBLE LIQUID, N O S (USED OILS&MIXED OILS) <br /> NA 1993, PG III <br /> ❑ ETHYLENE GLYCOL NON-RCRA <br /> HAZARDOUS WASTE LIQUID NO PLACARD REQUIRED NEXT SERVICE DATE <br /> ef/U S DOT DESCRIPTION - f / `I '"' DRUMS <br /> i <br /> MANIFEST NO '� k'"` NO OF GALLONS <br /> DRIVER �l r 'f".4"J ^'t TRUCK NO &RT <br /> DESIGNATED TSDF ❑ ALVISO INDEPENDENT OIL -5002 Archer St Alviso, CA 95002 <br /> ❑ BAYSIDE OIL II, INC - 210 Encmal St -Santa Cruz, CA 95060 <br /> ❑ BC STOCKING 7300 Chevron Way- Dixon, CA 95620 <br /> ❑ DeMENNO/KERDOON - 2000 N Alameda St -Compton, CA 90222 <br /> ❑ . OCS - 3256 N Marks St - Fresno, CA 93722 <br /> [� RAMOS ENVIRONMENTAL- 1515 S River Road W Sacramento, CA 95691 <br /> This is to certify that the above named articles are properly classified, described, packaged, <br /> marked and labeled,and are in proper condition for transportation,according to the applicable <br /> regulations of the DepartMent of Transportation <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED X <br /> THIS WASTE WITH ANY OTHER WASTE,AND THE <br /> TOTAL HALIDES ARE LESS THAN 1000 P P M CUSTOMER SIGNATURE DATE <br /> 1 FURTHER AGREE TO ACCEPT THE ADDITIONAL X <br /> CHARGES FOR LEGAL DISPOSAL 1F THIS WASTE h' � r! N <br /> PRINT NAME <br /> IS OVFR 1000 P P M TOTAL HAI IDES <br />