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POR SEFUJIC;E CALL: SERVICE ORDER <br /> DIXON Of4iC • ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-113 <br /> 7-800-7•ASBUR-lc V1f0 850 SERVICE ORDER NO, , <br /> PARLIEFi U11ODlYCl. �,.. <br /> 559=198-6240".;: <br /> cr-/ica <br /> AF 12 <br /> 800-733-9043 WORLD O I L <br /> ENVIRONMENTAL SERVICES. <br /> H STOCKTON DOWE INC 1300 SOUTH SANTA FE,COMPTON CA 90221 <br /> P. 3333 AUTO CENTER CIRCLE Los ANGELES oFFicE ISO BOX'MW <br /> P 1-800-974-4495 <br /> STOCKI"ON, CA 95212 TRANSPORTER EPA#CAD028277036 ST=CTON, CA 95208- <br /> T (209)477�3888 :'(209)477.3QM8 <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRU.CK,#, CONTACT NAME ORDERTAKERBY : HALIDES- <br /> ST0132.7 88 TACK 2Velezqutlu <br /> DATE REQUIRED DATE ENTERED NEXT SER IC DAT CUSTOM£R EIaR R BILL of LADING/MANIFEST 0, <br /> 2/22/2017 CAD9819876M C��f <br /> PART# DESCRIPTION' QTY UNIT PRICE. QTY PIU. ' TOTAL <br /> 55.Of.CM 55 GALLON Of r TOP DRUM(RECONDITIONED) $52.00 $58.88 <br /> OILY SO OILY SOWS PER DRUM �� $185.00 � $1,85.00 <br /> TOTAL. <br /> CASH RECD; ;CHECK <br /> WASTE DISPOSAL INFDRMATION' <br /> NON-RCRA'HAZARE)iaUSWA5T1 LIQUID(USED•OIUMIXED.OI'15) STATE.CO Dk 221 <br /> NON-RCRA•HAZAAbOUS WASTE;LIQUID(ETHY.LENEGLYCOLSOLU.TIONS) STATE COCE ' <br /> OTHER: <br /> DESIGNATED TSDF: <br /> ALTERNATE TSDF.: <br /> X ,j .'.r'' <br /> DRUMS PIi3: I MPTP DRUMS: FACILITY: BSC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX).. <br /> diy signing below I hereby cerllfythat: , <br /> (Waste oil generator/customer.MUST check ONE of the following three boxes) <br /> []+t)I•havcgotrniecdanyoltlicwaslcilescrlbadabavcly,Ithariy'ntt+clhaaardous.viaite,snetoulhalldcotrntenilslFSSthagl,ty]dppm;and[hP+vtyiadaranoi[culnlnaNpCds-Ihivccomplkdwhhthe rcqukelnenlsal _ <br /> the appliwble Calllomla used ell m�nagcrpcm rcgulaikrns io detcrminc Whit is triic_l agree.lo xcept the addsdonaychaagcs•Ioe Up disposal oflhli.Hsue if Ow Information l hivnp:wldrd about this waste is incorrect <br /> 1�s7 I havenal n%11xrd slit'of thewastri described obu a With any at her hasardotrswaite.itsa total h,alide content ll 64EATERthan 1,000ppm,and the wastedoes nn writnip any PCBs.I <br /> have prarSdrdproper doturrtorxasion tp Wprld t7j1 EnrlrcnzriCntwl Srrvlee•s tamb�r the prpsnnspllan thaulrls wasur,was rnlxrdwllh orher hi�anfous wxslr.l agrgetnaccept Ihcactdnlonal charges for the dlspow(orchis <br /> waste If she Infdrm�uen I hour rirovided Is wane it I".!reti <br /> L__Jy])ThhWastekfromosanksvhlTI callixtswriteoilhomhourehotd^do•ltyourself•,(OIY)and/or cartdrllonallyexern;ltsmallquanlltygenoratrk(CESQG)sourcm,Tothe best q;myknnwludge,the only waste oilcorswitwd <br /> In myICB5 'collectlon`rank IS tine)From DIV anuVot ME soureet•I have Act m14111 this warm NI Withany other harsrfluv>,wastr or waste oil from oilsri SIMMel,I ogler to a=pt the additlbnal charges for disposal <br /> of this swsled IhclnfoM4IiII I have pimW d kmrt this waste h usemmI. <br /> (All generators/customers MUST-read the fol lowing.text and check the associated box.) <br /> en I If l oma largettuantlty gQncratar,I CcitifyNt.I 1-mi a program In plate to reduco the voltrn!and tonicity dlwaste"rated to the device t have dNcrmined to lie cconomlwllypistlicable and that t have <br /> rccod the prv"cattle method pf area miens,storage.or tusposal curve ntty'xvaitabla to Ino whkC mrn{mlcrs the prosctrr■CI fulwe MM)t to human Ilre and the environment:Or,if Iaht+l;mall qumlity generolol,l <br /> twve made a,goad Iih offorl In minsirislla my wase 9ummxt lion and:ere cCtht bdst wine ma naryatnent.metiI that I:awntlobie to I"that can ailord. <br /> This Individual signing In the space set forth below on'bchalf of Customertepre�cnts and warrants that he/she has the authority to'bind Custonfer,that the forgoing desniptlorn of waste and m3teda15 ate true and,Wcurata <br /> as packaged,marked and labeled,arc ready for IransporIaIian in accordance with a pplicable state and federal reg ulaIIons,and that Customer shalt abide and bu bound bytho Sta dT7 and Cond4lons on the reverse <br /> side of this Service Order. j <br /> Custpmer ignatu -,Date river5ir�n tore . _ Datta. <br /> Pri(A Name Prin Drivers Narrle-' <br />