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y' SERVICE,'O.RDER
<br /> FOR SERVICE CALL: j. r
<br /> PARLIER ASBURY CNVIRONMENTAL SERVICES, DBA FORM NO.WQES004-D (1/17)
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<br /> 559=498-0240' WO 550 ` I SERVICE ORDER NO.
<br /> h ivi _ K
<br /> FORACCOUNTING CALL: WOGfY 0 N24139855
<br /> 562,-2t4 ler 1550
<br /> AF 125
<br /> WORLD-014
<br /> ENVIRONMENTAL SERVICES,.,,
<br /> s STOCKTON LODGE INC 14287 EAST MANNING AVE,FA'RLIER CA 93648
<br /> P ;.333 Auto CENTER CIRCLE 1.-559.-4.98.-0240 pp BOX 8009
<br /> v WWW:WORLDOILCORP.COM
<br /> E
<br /> STOCKTON, CA 95212 7RANSPORTER`EPA:#CAD028277036 STOCKTON, CA 952Q8
<br /> T .209) 47738158 �2(9)477-3688
<br /> CUSTOMER# PURCHASE ORDER# ROUTE.#• TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES
<br /> S T0$27 avalazquez
<br /> (DATE REQUIRED DATE ENTERED,;: NEXT SERVICE DATE. 'CUSTOMEREPA# 131LL of LA DINGIMANIFEST p
<br /> 11/6/2017 CAD981987880
<br /> FART kDESCRIPTION, QTY UNIT PRICE QTY P/U TOTAL
<br /> OFD OIL FILTER DRUM: . 4 $4,00 $0,00('
<br /> lip 03ma s to sWarata find puncture .BATCHWeebs-
<br /> _ -
<br /> . TOTAL•
<br /> G4S
<br /> CHECK'# Acccur t t6ar15w,Stave GatGat*H:REC.r[3 -
<br /> WASTE DISPOSAL INFORMATION
<br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) 5'fATE C6DE•221
<br /> CIN-RCRA M iTARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS), S-F,TE CODE
<br /> ,OTHER:
<br /> DESIGNATED TSDF:
<br /> ti
<br /> ALTERNATETSDF: -.
<br /> DRUMS P/U: EMPTY DRUMS: FA&ITY:- BSC
<br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX)
<br /> By signing below I hereby certify skate .
<br /> (Waste oil generator/customer MUST Check ONE of the following three tuxes)
<br /> r=Jr1)1 hame not n,tar;dafly of the waste de;s:tlbed uboyrwilh any oilier hatardasts wasse,Ilhe notal h4lilile canicnt is LESS Omit.,Acid pians and IIw waste doe.nos tOnt slrrady KUL 1 have eompUedsyith the"ultemcnH uf
<br /> the ayplls W.Call rgl Ila used of man.,gen•oil.iepulatfons to determine thla is true.l awe.I*accept Tile addieo lc6ges for Ihedlsposai or Iwt wane if the inrormadgn I harm psttrilded atamn this wasto Is IncorcYI
<br /> Q kg I have wet m110 any of dlewasit!desetibed above vrith any othet harudws wattr,lllc,loud halide cuhirMli6flEhTERthin 1.0L ppm Doll Iht.wasledous not contain arty frcac I
<br /> h4opspvldesi,tsmisel4 curslerualian:a Worfd Oil Envilc irriaNal Suvices to rebut INpr�umpfimr that thl}'v+dmv..sws nluiedwlth other ha ardaus waste,I agree So accept sheadditioml elwrgus for the ohpasalpl this
<br /> wastq#tk,,Infofmation 16"fi3OVWed ab«µcilli wasteh kINTIVO -
<br /> A,.J.
<br /> IDes4This wassa i.fr4m 4 lank wh l4h cmiiecu masts•.of ham howA hold•do•11•younrlf'tOiWl andler eonid4lonally reca ipt$MIjquaniltygonerslaf iCE500 sosrrtoi,to the hest of my knowledr p,the anlyw.,stc oil concalrim'
<br /> in nriufj cg5ols 6rkililn call:i1 salty ream OlYLvw6i CESQG saurces..l has%not mlred this waste,pil.wllh ahj41116 4S4rdtwi Eiastl or waor est rtorn other:ourek I aryrre f ornccepi the ndtllpnnal chahjes for dl;patial
<br /> of thn waste it the information I horn prrsvrdcd about IN,waste h IncatetYt •.
<br /> (Act generators/custorners MUST read the following text and check the asscidated boxj
<br /> N4i 111 am a larsac quvsthy generator,I it r l Ify shat I ha ye-.1 pi ograrn In place la reduce Tile valtrhre and tmrklty of wjsi1 ogehvroild In thv dugw o I haul:amr mined to he loon omic ally pracllcahlr and that(have, '
<br /> s. the 1r+acllWltle mclhad of tfcaune nl,storage,W,LSpeLal�urrenity A'railnble Ser me which minFmlYe3 till�s!s!fhS and f4tule Theca[to hurrah hfd and the vnvhohminl:Or,d I am a srhaQ quantay gdncr5wr,I' ,
<br /> leave(rude a good falth effort to minimize my wa ft generadoh and satoet INC beer Waste rrW wagemedl rriediod Ilial Is avillab?e to Mil Ifrat I Can aflerd.
<br /> This individual signing In the Sp.,Ce set forth below on behalf of Customer replrsont.and wan ants iliac helshe hos the authority to bind Cutiorngabldca
<br /> gdrKdpltors d waste and matedal5 are true and accurate
<br /> t a.packaged marked and labeled,are ready for transporWllun in accordance with applicable state and federal regulations,and ihac Customer shoond by die Standard Terms andCondrtlons on the reverse
<br /> side of this Service Order.
<br /> st e1r Signature R n Date DriverSign t Mn, 71�� f Date
<br /> _ 4�v►4l 1 Y5'"� YJ t.r+� _ �_
<br /> Print Name Print Drivers Name
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