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FOR SERVICE CALL: SERVICE ORDER PARLIER' ASBURY ENVIRONMENTAL SERVICES, OBA FORM No.WOES004-D (1/17) 559-498-0240Q5o SERVICE ORDER NO. FOR ACCOUNTING CALL: 562-231-1550 WODIY 0 t AF,125WORLD OIL / ENVIRONMENTAL SERVICES. s 14287 EAST MANNING AVE,PARLIER CA 93648 " STOCKTON QOWE INC 1-559-498-0240 v 333;1 AUTO CENTER CIRCLE WWW.WORLDOILCORP.COM PO BOX 8009 E . STOCKTCON,CA 95212 TRANSPORTER EPA#CAD028277036 STOCKTCNI CA 85208 0 (209) 477-3668 (208)477�31!168 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDERTAKEN BY HALIDES 8TO627 124 SCHEDULED-1 DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# ' BILL of LADING/MANIFEST# 9/22r2.017 9/2=017 CA17 1 SA786Q 4 PART# DESCRIPTION QTY UNIT PRICE QTY PIU-- JOTAL WO. Ust o OIL/MIXED OIL'S 394 50100 $0.00 WOSC USED OIL SERVICE C-HARGE 1- . $.60.00 584.00 rCH Of on Sireef ' TOTAL CASH RECD: CHECK 0 Mcmut Maniger 5t"t3at . WASTE DISPOSAL INFORMATION - 14014-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STAATE,CflDE 221 '-OQN-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE'. OTHER: —-- DE'S iGb ATED TSDF; ALTERNATETSDF: ASBURY EWIRONMENTAL SERMCESCERES,19M MOROM RC.,CERES;CA Wd369(206)641-1826 CAU=3,93880, DRUMS P/U:' EMPTY DRUMS, FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) Byslgningbelowl hereby certify that: - �� (Waste oil generator/customer MUST check ONE of thefollow- Mg.three boxes) �2c.01 have not mixedany of thewastt descanbed 6.bo nth any other hatardous Wti5tr,the lGrathallde Content Is LESS than-t,4Df}ppm,,nd the wastiidbmndt contain any PCBs.I have compiled with the requirements of. / theeappUeable CaBfomla e.!used oil management reguloSlans radetarnllrse this i7 truagree to accept the addltldnal charges for the disposal of this waste if the Information I have provided about this waste is incorrect E3021 have not mixed any of the waste dtsulli above with any other harardatrs waste,the total halide content Is GREATER than 1,00(1 ppm,and the waste does not contain any PCBs I have providedproperdocumentation it)World WErrAronmentalServicestofebutIheprctiurrWtionthatthiswasIawas'mixedwIthotherItazaidouswaste.Iagree toaccep the additionaIchatries for the dlsposalofthis t' Waste If the Information l have provided about this waste Is Inconect ••. - ' 441)Thissga9el1ftortatu which CMICCLi-alit o1)from fsoµsohoid'dn•II•yourself'IDIYIand/or conditionally exernpsirlullquantitygenerpt0i(CE50G)sources.To the best of my knowledge,the only waste oil'ccit ..d in my DIYI CEM tolkctfo(Lm"Itis sotey from DIY andlof CESWG,oui t have not mixed this waste oil with any other Hiard mr,waste or waste oil from ocher sources.l agree to accept the additional charges lo)disposal of lhitwosleif the IntiormatlCn I have provided iba+t thltwaste is hltmreeI (All generators/customers MUST read the following text and check the associated box.) 3;49;f f am a larft a pogr quantity generator;I certify that I lure ramths PMr:to reducen+a the vnhranJ lo .n .kily Orwee generato ted to the deprae I have determined W eeonamkaSypracdolga and ve 11011 ha Witted the prat 0 a4fe method of tteatmml,star ago.w dlsposal rvirenllya4ailabfo Io me whkh minim ms the presort and ftlttrre threat to human life and the crrvtronmonl:[tr.If i Aril o srrlaR quant tly gongs not,I harem atte a good forth effort to mtrtlml_m mywastc genoratlo,and ulcer the hest w3stemanagamenssnolhod Rias Is xvaliabie to mrthot I can alfard This Indlvidiwl sig tiring In the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer t' e forgoing descriptions of waste and materials are true and accurate as pacAagmi mar"and labeled,are ready or transportation in accordance with applicable state and federal regulations,and that Customers 14; and be bound by the Standard Terms and Conditions on the reverse side o!this Servke ' cr. f 1-7 Cusco er 9 re Date `_ river Signature ~Date tint Name Print Drivers Name