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SERVICE ORDER <br /> FOR SERVICE CALF_ <br /> 01X0 OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-B <br /> T-800-7 ASSURY WO 850 " SERVICEfJRDER N0. <br /> PARLIER y 1llSfOD Y 0 N=4798 <br /> 559-498-0240' r I w,..• . <br /> CHICO AE 125 ■ <br /> 800-733-9043 WORLD O I L <br /> ENVIRONMENTAL SERVICES., <br /> H STOCKfON DODGE INC 1300 SOUTH SANTA FE,COMPTON CA 90.221 <br /> p 3333 AUTO CENTER CIRCLE >. LOS ANGELES OFFICE PO BOX 6008 <br /> P 1-BQo-97+4495• <br /> 5rOCKTON,CA 95212 TRANSPORTER EPA ik GA00j8277036 STOCKTON. CA 95206 <br /> o '(209)477-3883 .(209)47.7.3088 ; <br /> CUSTOMER'# PURCHASE ORDER#. :' ROUTE# TRUCK# CONTACT NAME. ORDER TAKEN BY ' HALIDES <br /> SP0627 '' 68 �� ZACH squint�ana <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL&LADING/MANIFEST A. <br /> =112017 CAD981967880 <br /> PART# DESCRIPTION QTY UNIT PRICE. QTYNU TQTAt <br /> OFDR OIL FILTER bRUM REPOCEMENT-NO CHAROE t� $0,00 <br /> OF USED METAL.OIL AND,-GASOLINE FILTERS –4 - - 555,00 r $55,00 <br /> 1 OF I MET U.. BATCH 0 <br /> 31i6eft, . . <br /> 'TOTAL, <br /> CASH RECD: CHECK•#.• <br /> WA STE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED bILYMNED biLS) STATE CODE 221 <br /> NON- RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE. <br /> OTHER: I+IOti•RCRAKUARb! iAS WASTE_S-gM a(ELTERS c;QurA[yINC�QIL1 STILTj�.�(p��:1 --- <br /> DESIGNATED TSDF:_ ellMAi Y L�'2PJ�T ��Fe MAFA,2 g <br /> ALTERNATE TSDF: -- - ----- — <br /> •�n-�€C.-Y6�1�6-€AS!'�i-STr'�5•C�•- 1+l9E�E�u-=��ne��.�.'.-338 .;__ �. <br /> bRUMS PIU: EMPTY DRUMS: FACILITY:_ BSC <br /> GENERATOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE BOX) <br /> Ry,:ryiung tc.nfy that, <br /> (Waste oil generator/cu5tvmer MUST check ONE of the following three boxes) <br /> C1 <br /> IF III have not milrodaneor Ihn w;kstr descnhtrdahovc with any vthet haznrdgus waiter Ilse total Wide contact fs LESS than 1,000 ppm,and the waste does"I to win any PCIJ&I have complied with the iequlierlrits of ' <br /> the aj-prcable CatiforNa used oVl management r"")kM to detetminetllls N Dirt I agree to accept the additional charges fortho dispdtat of this wasle if the Iaatinarlon I have provided ahout this waste Is Incorrect <br /> [=a)I have not mixed;my of the waste ditwrlhed abov4 with nny ci hazardous waste,the Intal halide content is GREATER than 1,000 ppm,and the waste does not contaln any Kos.1 <br /> havepravidedproperdocumentallarktoWar10oilEnNron+nentallSaWcestore6utthepresuipptionthat.thiswastewasmixedwithothtrhazardouswxstti.Iagreet"cepttheadditionalchargesforIhedisposalofthis, ' ' <br /> wmui Il the infonrutien,I have provided a�ui thl;wa%ho is incokce <br /> M4131Trtls waste Is from a tank whlch[ollecu J+atso oR fmni housrhold'do-It•ytiurself'(DIY)and/pi conditionally evempt small quantity gamcatar(CESQG)sources.To+the best of-my knowledge,the onlywagi ell contained <br /> fn my DIy10ESQG colfactiah sank is inlay from 07'r arwgJde[E5[]G sources./have no[mixed this wasto oil With any athe.r hazardmas wastedtwmte oil from other sources.I agree to ettept'the additional changes fordlsposal <br /> of thlt waste if the inlormadon 1 have provided about they waste lsIncorrect - <br /> (All generators/customers M(I5T read the following text and check the associated box.) <br /> Al H I am a s rge" Ily genesU04I evrdly that t!*Are A program hlptaco td taduce the volume and tcoichlo f wasleglneratcd to the degree I have determined robe econom co]ly pmcls5ulc and Ilsal I have <br /> Jeered Shepractka:method of teeatmenl;sInT.-O,ar ditpesa?Mrenlly avAW&to me which ihinlmfees the present and future threat to human life and the environment;Or,if I am a small quantity generator,I <br /> have madea mood laiih rffmt W-Iramim mywavtrgonetatldn and select thf kiest waor managemcnr method that Is available to me that I can afford, <br /> This individual signing in the space set forth below on behalf of Customer represents and Warrants that he/she has the authority to bind Customer,that the forgoing descriptions of waste and materials are true and accurate <br /> as packaged,marked and labeled,are ready for vanspor Wt ion In accordance with applicable stale and federal regulations,and that Customer shall abide and he bound by the Sundatdjcrrtnnnd gondtitont on the reverse <br /> s ide of this Service Order. '+ <br /> Customer S19 nature Datefiver 'EJFtature Da <br /> PIK hlaZ� } rint Driers Name 0, <br />