Laserfiche WebLink
FOR SERVICE CALLOO SERVICE ORDER <br /> DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO, WOES004- B (4/17) <br /> 7 - 800•- 727-2879 <br /> WO 300 '` SERVICE ORDER N0, <br /> FOR ACCOUNTING CALL : <br /> 562-2374550 " WODIY <br /> ! d <br /> AF 110 <br /> WO PoLD I <br /> s <br /> ENVIRONMENTAL. SERVICESTM. <br /> P REEVE TRUCKING - REE008 7300 CHEVRON WAY, DIXON CA 95620 <br /> 1 -800-727-2879 <br /> e 5050 CARPENTER RD WWWWORLDOILCORP, COM PO BOX 5202 <br /> D <br /> T <br /> STOCKTON , CA 95215 TRANSPORTER EPA # CAD028277036 <br /> (209) 940-2623 STOCKTON, CA 95205 <br /> (209) 9400102623 <br /> CUSTOMER # PURCHASE ORDER # ROUTE # TRUCK # CONTACT NAME ORDER TAKEN BY HALIDES <br /> REE008 VQg L? 2 c L' CER-86 jstanton <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA 4 <br /> - 1 /B�ILL of LADING/MANIIFEST # <br /> f l ` <br /> 1 /31 !2018 CAL000333052 01 - 6 ` 6 t 3 J <br /> rPART DESCRIPTION QTY UNITPRICE QTYP/U TOTAL <br /> PARTS WASHER WASTE <br /> PARTS WASHER SERVICE CHARGE 40 $ 1654 $p QO <br /> 2 $ 165. 00 Z $359 . 70 <br /> BATCH <br /> Crops Streets ' <br /> TOTAL <br /> CASH RECD: CHECK # <br /> Aacaunt• Manager: Steve .Gately <br /> WASTE DISPOSAL INFORMATION <br /> NON -RCRA HAZARDOUS WASTE, LIQUID (USED OIL/MIXED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) <br /> OTHER: STATE CODE <br /> _ <br /> DESIGNATEDNTOST-*,1CRA H Rt)QiJ&UUAuTE i IQU1D f tH` 1rNATi R)":;iY�TC-t'r3F3 13> <br /> _ -- <br /> — ALTERNATETSDF: ilE ENId011<EI�DOOIV, '2pQ0 N. AI.AMEDA SffiEl , COMPTON, CA90222, ( 1Q)53"1- 71pU, CATp8001352 <br /> DRUMS P/U: EMPTY DRUMS: FACILITY: BSC <br /> GENERATOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE HOX <br /> By signing below Iherebyceitifythat: <br /> ( Waste oil generator/customer MUST check ONE of the 'following three boxes) <br /> M41 ) I have not mixed any ofthe waste described above with any other hazardous waste, the total halide content is LESS than 1,000ppm, and the waste does not coGt Com rl edp <br /> the applicable California used oft management regulations to determine this Is true, I agree to accept the additional charges for the disposal of this ntainiswaste If the (nformalion I anySs �h <br /> P <br /> 4 <br /> o> fe`dulsoui•thl1viasiCr'P �i'co'!°r cttnbv( <br /> C] "21 have not mixed any ofthe waste described abovewith any other hazardous waste, the total halide content Is GREATER than 1 ,000 ppm, and the waste does not contain any PCBs. I <br /> have provided proper documentation toworid Oil Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste. I agree to accept the additional charges for the disposal of this <br /> waste if the information I have provided about this waste is Incorrect <br /> In m This waste G from a tank which collects waste oil and/or <br /> ESQGhousehold 'do it•yourself" (DIY) and/or conditionally exempt small quantity generator (CESQG) sources, To the best of my knowledge, the only waste oil contained <br /> In my D!asCESQG collection tank Is Soley from DIYDbout this waste <br /> sources, l have not mixed this waste oil with anyother hazardous waste or waste oil from other sources , i agree to accept the additional charges for disposal <br /> of this waste If the Information I have provided about this waste Is incorrect <br /> (All generators/ CLIStomerS MUST read the following text and check the associated box , ) <br /> i If 1011141 largequantlly lit'llwotot I certify that I have .) plopidm In place In teduce the volume and tosidivOf waste generated to the degree I have determined to be economically practicable and that I have <br /> bulml the practkablo method of frea inPul, su;iage, of duposal Currently a ilable to me which "11111m,17105 the present and future threat to human life and the environment; Or, if I am a small quantity generator; I <br /> h, se niada a good faith effort to mininiz my wase gel*taUun ain15Otc1 1)t- bldslwasu• mana 9 pm(mi in PIhad tIIat is availaIll e to methat I can afford <br /> This Individual signing in the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer, that the forgoing descriptions of waste and materials are true and accurate <br /> as packaged, marked and labeled, are ready for transportation In accordance with applicable state and federal regulations, and that Customer shall abide and he bound by the Standard Terms and Conditions on the reverse <br /> side of this Service Order. <br /> CUs rte Sicji�4ture Date �7- <br /> Driver , i , I attire L r <br /> Print Name '"' <br /> Print Drivers Name <br />