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i <br /> FOR SERVICE CALL: SERVICE'ORDER <br /> PARLIER */'y r+ ' , ASSIURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOLS064-b om7! <br /> 559-40 24 sl .�: ry rays. t t ;":ii ';'• SERIIICEORDER NO. <br /> r ' <br /> FOR ACCOVIYTING CALL 1f�DI�IY❑' N2578178 <br /> 562-231-1550 At 120 <br /> ' 1 <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,. <br /> STC)N t?aDGE INC 14287, EAST MANNING AVE,PARLIER CA 93648 <br /> " 3 AUTO CENTER CIRCLE 1 sss 4 8-a24o PO BOX <br /> P WWW.WORLDOILCORF'COM <br /> E S TOCKTON,CA 9,6212 STOCK70N,CA 95208 <br /> D (�k.477_WIJg,, TRANSPORTER EPA#CAD028277036 � 3 477 <br /> 1 <br /> CUSTOMER 8 P.URCHASE'ORDER# ROUTE# TRUCK# CONTACT NAME ORI]ERTAKEN BY HALIDES <br /> C 1 d.14Cl Cr <br /> DATE REQUIRED, :::; DATE ENTERED NEXT SERVICE.DATE CUSfOMER'EPA# BILL of LADINGPN ANIREST Ii <br /> i I <br /> PART I! DESCRIPT16N- QTY UNIT PRICE. QIY P/U• TQTAL <br /> -USED t:SERVICE CHARGE <br /> Wp,:— $ED.01:0.MIXED OILS .420- $0.00 '$CLO() . <br /> BATCH tF[ <br /> Cro 5SStreefi : Gat sIgna re 6 m''Cary. <br /> TuTAL <br /> CRSH R1:C.'IJ: G--HECK.k' <br /> WASTE DISPOSAL 0 F4RM0O'N- <br /> NOlV-RCRA HAZARDOL6WASTE,-LIQUID'(USED OILIWED OILS)` STATE C6 E 2.7.1. <br /> NOIV'RCRA HA2ARDL7tJ5VdASTE;LIQUID.(ETFIYLENE GLYCC]L SpLUTIQNS) ' STATE CODE <br /> •OTHER:. •. : -. •...� -: ... -.,.. . .• .. .... . - . .. �• . . . •_- •. . - .: <br /> OESIGIVA'TEDTS6F, psSr JRY E71f11lROHlYI {f1�0.E SEf[VICESCER Sr?@ 11laRCytiRN RQI�CER $�;CA'963W(2Q T-11 8;. Nf39�BB� <br /> ALTEpNATE750F: — -- -- - <br /> ► DRUiyiS PIU: EMPTY DRl1M5: -, FACILCCY: ssC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) <br /> [i below I hereby cirllfy that; ' <br /> (Waste oil genera tar/customer MUST cheek.ONE of the following three boxes-) <br /> =JA III have not mixed arsycirthe waste ileseerbvd rh7rR will[any other ha2artJv[n Y1�:te,t�'11!l�eal hv7do ronkot I:LESS 1}4717 1.0dappm,4r4Ah,,WASItsfoei nut coritssin arty Pl i,i hwecnmplicd with IhCtttlulrcme fti s of <br /> Ike applie wo Calllptola used oil managenxmt miumum.0 Indolrknlne Nos L[ud.I agree la xccptihii addtrtpn3i LhAr9cs(14tise dispoiol otihi7 waltr if ihe]nformatlruri have piWided.ibvul mi vras it inKnrt.r'[ <br /> =1 02.1 have not mixed any or the waste destribr:dabos•r with any othor ha:aidvus was lc,the total luilrk itantenl tt GRMTER 0011 I,Ckpp p}frn•and the wa rte Bars tltN contain:i ry pClis.f <br /> It"0.01ded piupm dotumitntatidn,lo Wild Oil Envirvrungnlsk Seirkes sq r@butlAo•pecsun[priors}7+a1 this wasteWeI nuxed wish alhlr Ilaztirdoui.ssiaslc:l a ceto acceptillenddl001714l"gel far like dfipasoI,of}his <br /> -*A U6 ii rile infotnladoo I,hasw 06M td aloft l tills waste Is Ikorrect <br /> 1-a311hlfwastchfrom a.mrJrwhkhcollneca.Acte'ollhcmhovsr:ftokldr>A'Nvwe{l'IDIY},}ndfdrrarldlllvtkaltycaemptsmall}ua ��lyguriesm?iIGrSCGJsaprceSTDthe,Iestoftigk"ledge,th!onIjywivebnl <br /> llcoaiiied <br /> in my 0tv f CESQG s oliection hills is coley from 01Y atn11 lru <br /> W CEM: tca r.i tiavo nal mixed hits wuue ail iwh h,srsy adwit Itaiardatlwo Ste or swstc,011 from ather'SVjrces.14s 4,to ba0pt the addidomrtllaiya r For disputa I <br /> of.thlS shute.IF the Gifw rnmiun t harm provided aboul fhls waste is IncohecI <br /> (All generators/customers MUST read the Following text and check the associated box.) <br /> Mj%;IFI Am a tarp quanblgen cratce,I crrUfy 01411 havdA plagrafrl IripG,6c to FeducC the VolwPv'and tpyidly of waste generated m the drgmc,I hasx rte ter mined N1.be cc oriomically practicable and than have <br /> to c,i:Te f tho prxticatrie me[hocl of trcatrrien;storage;or&poral cunMtlyavadaiste so fNd"SF""I I'll <br /> Mini"Illm The prctent andjtnyty thrdal to human life and the on0tonm"t,Or,II I am a small qua ntltygenetNor,I <br /> hacrmxW agwel1411h eKdr1 to nal-Inlit!mywa}ld gt Mtdeh•,kid selecs the best Hatt.11-Axp.G.m.crit ristoed trial is wwl.7t:ie olo that I ran affo[d. - , <br /> 7hbs Individual signing In the spite set for lh below on behalf of Cussomcl rewrs!ms and waAaTiis that hcRlw ha:the.,iushorhy to bind Customer,Out the forgoing descriptions of.aste and maredals are vue and accurate <br /> as packaged;maiked and labeled,aro ready for t[anspa[tatson in acconlame with applicable sta[rsnd ferlwal rnlulatwn%Aird r6at Cpstomer sh al(alkide and be.bound liy the Stan.:..ird Terms and Condition.on the roverse <br /> We of this Service Order, <br /> Custofger Signature ate �—DriverSigna re ?)rite <br /> Print Name_ Print Drivers Name <br />