Laserfiche WebLink
FOR SERVICE CALL: SERVICE ORDER <br /> AARLIER " ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004=D (1/17) <br /> ';597498-17210. wo 650 SERVICE ORDE=R NO. <br /> FOR ACCOUNTING CALL: V+/O[31Y'0N247T175 <br /> ` <br /> 5G2 237-1550'. <br /> AF 125 <br /> WORLD OIL <br /> E.NVIRONM'ENTAL'SERVICE8,. <br /> S <br /> '14287.EAST MANNING AVE,PARLIER CA 93648 <br /> H S{OCKTON bOf�GE INC 1-5544498=0240 <br /> P . 8333'AUTO 08NTER'CIRCL E www.wOt�LDOILcORF QOM PO'Box 80M <br /> E <br /> T STOCKTON,CA 95212 TRANSPORTER EPA 4.CAD028277036 STdCKTCJN, CA 95208 <br /> ° 009)4.77-3888 (2{l8)477-38'88 <br /> CUSTOMER# PURCHASE ORDEJR <br /> ROUTE# TRUCK# ' CONTACT NAME ORDERTAKEN'BY HALIDES <br /> STQ827 Wl1 -124 dDsCHED.PLED-,I, . <br /> DATEREQUIRED DATE ENTEREDNECi SERVICE DATE CUSTOMER EPA# BILL'of LADING/MANIFEST# <br /> • �7 g r <br /> 11123/2017. .11/21,8017. CAI098 <br /> DART P• DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL <br /> WOSC USED OILSERVICE CHARGE 1 $80.06 $80;00 <br /> Wil' u§f5b OIL:!AJIIkEOILS . .' 300 $0.00 30.00 <br /> Cra 5 Streets:: TOTAL. <br /> i S <br /> CIt;H s3EC'L7::__•,-.— — CHECKA Aawunt Ililul'raw.Steve pxtely, <br /> WASTE€ ISPOSAL DEFORMATION <br /> NDN-RCRA HAZARDOUS WASTE,LIQUID(USED 6L/MIXED OILS) STATE CODE 221 <br /> NON R(_.FiA HAZARD OUS WASTE;LIQUID(ETHY.LENE GLYCOL SOLUTIONS) STATE CODE <br /> OTHER; -- — - -- -- <br /> I .n!tDTSDF:_ - <br /> ALTERNATETSDF: ASiIE1EdYE7rt�iRoTdMClyTltt 5FRYIIGI SCE�,ES iF7ZfTI9I413CitRf9RITC- 1.U.$j63T."183.C.fS 003MOld <br /> DRW"S PIU: EMPTY r7RUNIS:� FACILITY: <br /> GENERATOR WASTE CERTIFICATION'(PIEASE CHECKTHE-APPROPRIATEBOX) <br /> Ry tignlnrf bclnw hcrrsty cr�rtlfy Char , '. <br /> 'j (Waste oil generator/customer MUST check DIVE of the follgwinco three boxes) <br /> I11 Itwd net nif><ed any of rho wase def nrDcd ahma svnr+any eihtf hazotdeus wasic,rho total Halide conienr r1 LE.'S 1nun 1,c1dd ppm•aryl lht'wacretFPrsnor tnnlaln airy i•CBs.I have Carnrrrrtd wish the requlr{m ? of: <br /> the appIJC iJt r Catlfw nia ut5it art mnnagervent seg ulasions to dcicrrolne this is true.I agree to accept I he additional charge{for the ditposal of thic waarp if the,infwmatlon t have provlded about Ihlt wasIa is Incorrect . <br /> Q+t I have not rnl.ed any orihr wasie}lrcrlbed above with any other hazardous waste,the total hallde content Is GREATER than 1.0;1 ppm and the waste does not caRWin any:pos,I <br /> ev]drdprpperaiorurnebtattoot,[oWorldOltErnhanrnCp1Ia15ervicrsto,mbotihepresu[niillop.lhatthis.wa:iewasml.x"wltpatherhazerdou5WWClagrei.toaccrpiSheodditionalchargesfor,thedISpSI4,11111; - <br /> 1Faa�If•trya tr+fgensation I ryava ptwklcd.abous <br /> CJ.r3)Thif wiisa h lrem tankwhlcs tepee is waitc ell Irum hdu?rhokl`r1 1 yotS sell'[�11y nndJoi ionilldonoily rtrmpba;ratl'sruar+fV[y gtnriatorICESC7G}'Aourcei rhrY e!skss of My knowlydgr,the,only waai�oA'constined' <br /> In nslifflYICESQG>;61alert ilnit Wwty frornowsrrvoi use sauirr::l tiaJr rias rnlxcsl this waste ell w;th my olltty huawUcui bvau4 yr wnsteoll frumblhcr soufers l auieo to'xapt the addhtontl charges ear dispoiAl <br /> Of shit wristlet Information I have Itrovlded about itils waste is Incorrect - <br /> S (Ail generators/customers MUST read the following text and check the associated.beic:) <br /> r4}Il i am a large quantity ycntrata+,1 certdy Ilsat I hawa program In place to reduce thewlume and scarcity of waste"rwnied to thet"fee t b,wedrtermli ed to Ire cconomkarly practicable arsd bloc i haves <br /> Sed the p+a[1167$ll•'mel bed of tiroerient•iborisge.cit dlsf usal cUffdally Ovaitibte to me whkh•trj rdlrrizts the prleWnt'anel future lhieat to humon life and the mulron merit:W,if I am a s+rraii quahthy gChiratal;I <br /> have mwfvayogd ralth OrFl{p 4ihlknlXe mil NraslDgeriryallon and rrilcct the bdit r+a:tr managrrrieni ntdtRod Ikst Is available to me Iful1 can arrwd. <br /> This it dMilual slurring in rhe space set forth below on behalf of'Cusromer represents and warrants that hdaiiohaa the oulhorlty to bind Ctittomer,th for ng descriptions of waste and maierlals era true and accurate <br /> 'as packaged,markedpnd labeled•are ready for iranspor orlon in accordance with applicable state and kddtai regoia6crm.and tfy7t Cusmrner shat v a pound by the Sumdaid Terms and Conditions on the reverse <br /> tide of this Service Crclec <br /> . i <br /> iQr� a �1 Date ve Signature { D'ate'' <br /> Print Name Print Drivers Narne <br />