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IFOR SERVICE CALL: <br /> + SERVICE`ORDER <br /> DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM N0:WOES004Ei <br /> 1-800-'7=A58URY WO•:680 SERVICE ORbER N0. <br /> PARLIER WODlY 0 <br /> 559-498-0240 r... .. .. w: N� 109Ef. <br /> •K A 1 <br /> CHICO <br /> 800-733-5043 WORLDOIL <br /> ENVIRONMENTAL SERVICESIM <br /> H STOCKTON DODGE INC 1300 SOUTH-SANTA FE,COMPTON CA 90221 <br /> 1 3333 AUTO CENTER CIRCLE LOS ANGELES OFFICE PO Box 8009 <br /> p 1'=Bao-974-4495• <br /> E STOCKTON,CA 9521:2 # 5"TOCK70N;CA 95X8 <br /> T TRANSPORTER'EPA' �AD028277036 <br /> 0 (209) 477.368$ (209)477-3M <br /> CUSTOMER Ik PURCHASE ORDER# ROUTE# TRUCK It r CONTACT NAME ORDER TAKEN BY HALIDES <br /> ST0827 > If 124 SCHEDULED-1 <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA N BILL of LADWMANI.FEST 9 . <br /> 2118 017 2i'l 201.7 CAD9619676M <br /> PART?I DESCRIPTION QTY UNIT.PRICE QTY P/U TOTAL <br /> WC} USED OIL/MiXED OILS $0.00 $0.00' <br /> I WOSC- USED OIL SERVICE CHARQE' 1 $80:00 $80.00 <br /> BATCH rR <br /> I; TOTAL' <br /> CASH REC'D: CHECK# <br /> WASTE DISPOSAL INFbRMATION <br /> NOWRCRA HAZARDOUS WASTE LIQUID{USED OlUMIXED'OILS) STATE:CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,-LIQUID:(ETHYLEN6GLYCOL SOLUTIONS) STATE CODE-- <br /> :OTHER: <br /> ODE:OTHER: <br /> DESIGNATEDTSDF:� gpd 14Y II6gld rRills <br /> ALTERNATETSDF: <br /> DRUMS P/U: EMPTY DRUMS:. = FACILITY---- BSC <br /> GENERATOR WASTE,CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) <br /> By signing below I hereby certify that . . <br /> (Waste oil.generator/customer MUST check ONE of the following three boxes) <br /> f <br /> III have not mi-ed Ory W the waste Jesdrr•v'd ahovewlsh ury utlior fussrdous wass,i•,the total I',tllsk CMlent is l[S$than I i000 porn anJ the waste data not sariLJn,iny PCOn.I have compiled.wvlth the rrqulrcments of <br /> / e applkxl'ila.Cartfamla utetf pll trtorragenrtnl Icgutagans todetsrmlrtrthis lstruc.l agree to accept the adJEtlunal ihargeS for the disposal of this wn:tRjf the infermdiIon I have provided about th1}waste IS Incorrect <br /> Iia:I have nal mired any to the write flu svihed alcove wrth any otbes ho rmclairswasse.1he total h4corilent Is GREATER than 1.000 ppm and the waste does not contain any i.Rs.I <br /> have ptryrldcd ptnper doCumnl'lallon to World D0 Fiivltonnwmal.Srrvf[es to rrfiut 11M p+ewnrpBan'tl'at this waste was mixed,With other hazardous waste.I agree to accept the additional charges for the disposal of thls ' <br /> waste If the Information I have provided about this waste is Iricomect - <br /> =all Tldswmse Is from a tynlr wNkh e011r••cf t,"si¢ell from household dcll•ybsrrulf'IDIY1 yndlur gar dhlonalfl exei'ipt urwli g0nllty generatt i(C[SCy6I sources;To the heir of my knowledge,she orrty waste oil contained <br /> In mytIFYf CES06 401CICiign lank Is wtv 11 Dirt Dry amVor CE503wulnm I have nor rid-od rhki twilt oil with any other hazardous isastp of waste ell from Other svurces-I agree to accept the addillorrd charges for dlsposal <br /> , <br /> of this waste if the lnforrna0nri I have W added about this waste Is inml re[[ ' <br /> (All generators/customers MUST read the following text and cheick the associated box,) <br /> ea11f i am a large quenusy glnevatw,I ter lift'lhat I lsavn a program in place mndu[e limp volume and loxlcity of write unerased re the ds$rce i have deter mined to be ecerromrrally pra Icabte and that I have <br /> ectad the practicahlc mcthvd o7lmalntcttt,ilarage.or disposal can"N",arsflablr to mo which minlmlzrsthti preseniind future Ih'eal to human life and the envlror'm!N';Or,If I am o srlull quantity generamr, <br /> lair made a good fail It offal)to rnlnti niie my wastd generation and irlect'!ie best wastL-ma nagement method IW is iwdi6ble to me that I ran alloni <br /> This individual signing In the space set forth below an lachalf of Customer represents and warrants that he/she has the authority to bind Customer,that the forgoing descriptions of waste and materials aret� ;accurate <br /> S packaged,marked and labeled;arc ready for uanspormtlon In accordance withopplicable slate and federal regulations,and that Customer shall abide and be bound by the Standard Terrns and CorsdlWalr I the reverse <br /> side of this Service D+ <br /> Lusty` er r tore Dale rlverSignfiN111 <br /> Date <br /> Print Name P' rant{3rEve <br />