Laserfiche WebLink
> ori s=R cit CALL: SERVICE ORDER <br /> DIxCf ICE ASBURY ENVIROPIMENTAL. SERVICES, DBA FORM-NO.WOES004-B <br /> 1-8CU7-ASBURY WO 850 r ': SERVICE ORDER NO. <br /> PA LIER WODfY 0 N2313823 <br /> 559-498-0240 1 . <br /> C1PCO pF 125 <br /> 30(�-733-9043 WORLD OIL' <br /> ENVIRONMENTAL SERVICES, <br /> 5 STOCKTON,DODGE INC 1300 SOUTH SANTA FE;COMPTON CA 90221 <br /> H <br /> P $,333 AUTO CENTER'.CIRCLE LOS ANGELES OFFICE PO SOX 8009 <br /> p "T=800-974-4495 <br /> D STOCKTON,CA'95212STOCKI`ON, CA 95208 <br /> TRANSPORTER EPA#CADO28277036 <br /> T (209)477-3858, (2.09)147 7-3M8 <br /> CUSTOMER# PURCHASE ORDER ROUTE# TRUCK.# CONTACT NAME ORDER TAKEN BY HALIDES' <br /> ST0627c rL O 124 ISCHEDULED4 <br /> DATE REQUIRED V DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA 9. BILL of LADING/MANIFFSTA <br /> 2/2/2017 2=17 CAD981967M � <br /> PART# DESCRIPTION QTY UNIT PRICE j QTY P/U TOTAL <br /> WOSC USED OIL SERVICE CHARGE $8.0,00- o <br /> WO USED CYiL!MIRE©O1L6 O,Op; $(30.190 <br /> BATCH <br /> -dras. Sh tb, - 4 air <br /> TOTAL <br /> CASH REVD:_ CHECK Ir <br /> WASTE Dipi iSAL INFORMATION' <br /> NOIR-RCRA HA7ARDOUS WAST£ LIQUID(USED g1L/M1xED OILS} STAT 221. <br /> NON-RCRAHAZIRtDOUS WASTE,LIQUID(ETHYLENE GLYCOL56LUTIONS) STATE CODE <br /> OTHER: -- — - - a <br /> DESiGNAItDTSDF:--A9 IrtOf�A!E � SERV!OES CER�B,� �� RC�AI��RI3y CEREtST C+4 8( 1" ,- GO <br /> ALTERNATETSDF: <br /> DRUMS P/U- -- EMPTY DRUMS: FACILITY: BSC <br /> ` GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) <br /> - <br /> fly,igninrjbrlowIhorrhyctnsifysl+ab <br /> (Waste fail 90erator/customer MUST check ONE of the following three boxes) <br /> tr I have mdi mlrud anyyartfie tsautdes[NLuni ahtiwi iv dt all 01hefha=ardour%atm[hit lain halide tohtant is LESS[hen 00 ppm and tha sl+asepdaes not c6nlwh Any PCES.I hove camithed with[hr rc,lulremerrU of <br /> ,ha appliciWe"&rnU uteri oll.rria»agamant regblasions[adntermine this Is true-tagfda tea[cepl the addldonal tharges ier the dlspowl of this Watie if the InforrnaLWn 1 havepsovtded abmn tills vea p itincalract <br /> n <br /> EMU I have ntst mhed am•of the waste doxilbed aboye%iih any Doha*hazardous waste•the toms halide cosrur nis GRFATER then 1.000 ppm and the wattedars not carown any,put F <br /> ha rpraxnlnl proper d acvpte0sarlon to wom oil EAvuann+entha <br /> ul semens to rebut the presumption tt tiles vrosic was mi+e4whh other hazardmrt waste-tagrer to aciepi the adstil(anal char0as for the dtspatal of tills <br /> ,rana.lf 41w In/0"110-1 sit I have,,,,i,,d a,asrt this wAste is Ins:ermKt. - - - <br /> fne mllowastn Ir}mm a tank which f ollttis waere olf from hoinchold d s•.t-/aunrls';[]IY]atvklorCorxlilfoniityetemprsmall quen[I[r gennratr r(CEM Saui"s.Tti the ixst oTr[y Jct owlcdryo tha onlywarte DR cantalned <br /> In my ON1 CE5Qd�;olikdw lank 1i salty fiam❑IY ndlar CE5'i.Yi souices-I have riot mfead ihtsv+aste aril with any elherhaz:ridausve sttrvctyaeie'ot1 from atl+rr sources!asjfre m accept[hr'addlheisat charges for disposal <br /> of INs%W Ile if the InfromatlDrt I haw pr m•tded ehout this Iva se k Ir.eun ect <br /> (AlI generators/custymers MUST read the following text and check the associated box.) <br /> *4111't am a largegw itmygenera[ar•I cattiry that I have a program in place to reduce the vo?umexnd tosuleyarx�strgr;rsrrarrd[o lire degTDe I have determined robe econaraka6y p ilukablc and that I have <br /> ted the pzactitahk asethad of t"atmonh atalatir,or disposat currtv,tryavailable tri ma which r1inoilzet the Preunt arjdAVtumthmat to human life and the env[ronmrM;Or,If I am a small quantity qumrmur,I <br /> madu a fippdfinh elfafl to F.0p jmfaP my wawa rrarativri and selro: the brsWa`l orranagpmen[musllod Ihar itav:Wlablr to Me chat I ton alfoid; <br /> `Phis Indirktual36q b j16 the I-Pecc am►efah below an kchAlf of[UflemCr represents and warrams that hWtho has tho,turhorhy to bird Cuuarner.I1ssl the rorgafng*Aflptotmiof waste and mmunals 411 to and accura[r <br /> as puio-wd,rrrarkrdand lalwie 1.are ready For iratnpew t attun ht au c+danre_vrlth npplka6ls state and fnsnat rrpulasiam,and Out Cquoroer th.111 ahsdD and ba bound by OwMandaunroms an+f C,amlrl Joni nn rbc rcvrr3r <br /> side of tNs 5e,vicr order. <br /> Customer Sicq tyre Date Driver Sipatur D <br /> ,/ <br /> �r � <br /> Print Name Print Driveis an e <br />