COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

FOR SERVICE CALL: SERVICE ORDER PARLIER ASSURY ENVIRONMENTAL SERVICES, DPA FORM NO.WOES004-D (1/17) 559-498=0240 WCl 650 SERVICEORDER NO. Affla FOR ACCOUNTING,CALL: WoOIY 0 N244979H 562431-1550' AF T25. WORLDOIL ENVIRONMENTAL SERVICES,. isi STOCKTON DOWi~ INC 14287 EAST MANNING AVE,PARLIER CA 93648 P 3383 ROTO CENTER CIRCLE 1-559-498-9740 PO BOX 8009 , P WWW;WORLDOILCORP.COM E D STOCKTUN,CA 915212 TRANSPORTER EPA#CAD028277036 STOCKTON,CA 95208' (�09)477 3868': (209)477=3688 CUSTOMER# PURCHASE,ORDER# ROUTE#- TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES i3TO627' ROUTE 124 SCHEDULED-I - , DATE REQUIRED. DATE ENTERED N�XTSERV ICE DATE CUSTOMER•EPA# 31 LL of LADI NG/M AN I F�9# 1014/201,77 1 OM2017 �A09g.1987�80 PART# DESCRIPTION QTY UNIT PRICE: QTY P/U TOTAL WO, USED-OIL)MIXED OILS ow '0 4 $0.()0. WOSC, ED USoiL SERVICE CHARGE 1' t�GiDo Cre ss StreetsTOTAL ;CASH REC'D:• `CHECK# •AcsAimt Adanis�eri StomGately, I WASTE DISPOSAL INFORMATION. NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE,CODE 221 NO RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE _ DESI NM ED TSDF-, ASflLAY-E NfIi0FllliEH'AL-SSEfE eES-eER,Er#0G-MORGAN-REI:;C ? S;@J4 B]6+i'k1t ; k$Eld3fi36 ALTERNATE P-DF: DRUMS PIU- EMPTY DRUMS: _ FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) By signing below I hereby certify that; (Waste oil generator/customer MUST check ONE of the following,three boxes) linvr not mtxad.any of the wutpdcKttL�tda4fove with any other ha:udoucwas'e,the lotal hallde content is LEU[hart l,oWppm,arid the waste daeiilof Cotisaln any PUL I hive compliM with the requirements of X:11_1 pplkable f sllfomla used oil management regulallons to delrrmMe Ilsis is true.I agfec to a"vial the addolonat rNitges fpr the dhrrq s d of IN$waste If the Wormatinn I have proy oed about this waste is incorrect OA21 have not mixed anyolthe waste dewilbed abovewRh any other hazafdow waste,the tool halide content Is GREATER than I,noO pp,n,and the waste does not centaur any PC&s.I .have provided proper dacunientailonso World Oil Erwhonmmital Services to rebut the prewroptian that this waste wasmixed with other tsaaordous wastr.I agree le 3=$rt lhearldltlorial charges for the dhpotal u(this waste if the inrormailon I have provided about this waste Is Incorrect Mr3)Thliwasteis(tarna,tank which eolleci wuteoilfrom houschoki'rla•it-you rsell'(DIY)and/prConditionally exemne ryl Small quantity gerator{�jGlsources.Toth+ebestofmyknowledge,the only wst aeoil coni Age d rn my DryiusOG c.sstintlon tank Is soley from Matlzlfor CESOG sowers.i hswe not mixed this waaa wt wtth,any whet]m7ardous w,Ute of waste od Irani other sources.l agnv)to accept 1ho addlllonal charges for dhrrosst of this wasto)(the information l have provided about this waste is Incorrect (AII generators/Customers MUST read the following text and check the as50ciated box.) .a)If am a large gvantnygenenoor,f certify Thal 1 Irpye a ptggram in place to reduce the%,aWmo and Imluty of waste gcnowIrA to IheAegrev,i have determined to betle0rlt)n11CaNy prxtkable and that I have sluyracikablC ase Ihod a1 treat men4 siarage,of dKpotal twrinily av ilfoble to rtsa srhirk mfui MIA3 dw pre smt and fulurn thrrot so humna lire and thn caw nt7 Ur,if aria a small gpanI it y.rienemtor,l h.Tvc rrsatic a ghat fatsh reforr ie minlrnize mywasse gcneral{on and select the host waste ntanigoment mctrtod that is available to the that I tan afford. This Individual signing in the space set forth below on behalf of Customer represents and warrants that he/she has the authorl ly to bind Customer,tha •fnrgetnq :enpSlens of waste and malerlal5 are true and accurate as packaged,marked and labeled,are ready for transportation in accordance with applicable state and federal regulations,and that Customer&W tde and be and by the 5tandardTc Cand Conditions on the reverse side of this Service Order. llstomer$Iignature Date a ignalure Date P Vnk Name Print ,hers Id7 me