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SERVICE ORDER FOR SERV110E CALL: , : t FORM (1/17)PAAVER ASBURY ENVIRONMEN11 C , -590498-0240 498-0240 WO e5(3 SERVICE ORD 3 NO. FOR.ACCOUNTING CALL: WOC)lY O N2545532 562-231-1550 0 AP 1Z5 �• WORLD QIL- ' ENVIRONMENTAL S:ERVICES,M S STOCKTO'N DOWC INC 14287 EAST MANNING AVE;PARLIER CA-93648 H =3 AUTO CENTER CIRCLE 1-559-4.98 424.0 P©WX 8009 p p wV11V wohLDOILCORP.COM sTocKTON, CA 95212STOCKTON,CA 95208 TRANSPORTER EPA#CADO?8277036 T (209)477-3W8 (2W 477-3Ei88 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDERJAkEN BY: HALIDES ST0627 CER-88 KC av®lazquez, DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADINCVMANIFEST# mai caD9819e7aso2._. PART# DESCRIPTION QTY IU TOTAL ,31!Y QlLI� ER M St85'00. ply i? 1 AS S00►i AS PO:-S) 9ATCH CM soft Gat.4i6f� b•ire€torri Casji. TOTAL CHECK#:., a"our*b1a :static 09*F• + _; ' WASC8,C45N34AL INFORiVIATIOiV NON.R_RA HA ARDCiUS WASTE,LIQUID[U5ED CiIUMIxE661LS)� STATE CODE 221 �NON-RCRA'HA7ARDQUS WASTE,LIQUID(ETHYLENE GLYCOL SR�Li nal STATE CEDE OTHER, ?r:•, - -- RESIGNATEDTSDF: ALTERNATE TSDF: DRUMS PIU: EMPTY DRUMS:r, FACILITY: BSC Y GENERATOR WASTE CERTIFICATIOP4(PLEASE CHECKTHE APPROPRIATE BOX)• 'I 4 slgnino bel'sw.l•IlnrrtW eWl.f y rhab . (Waste oil gelieratoF/customer MUST check ONE of Ote fallowing three boxes) - 1 mill;I hare+stst m1Red anyaf she waltedcxirlled pboee wish iri'sy ci hazardtius waste-the total halide cahtent It LESS ds art t AM ppm,and Ihewaste dory riot contain any PCBs.I lave a omplkd with the re�qulmmcnls of tiq ipplieaf it C.lhfprnia used ollmaAafJettjerst traguGjill todelefrritne Ih$Is hue,t agree to accept ilia al;kAsianal charges for the dlspwal of thtawaste If the InfwmaRan I have provkkd abounhls waslc as incorsert , []e2 f have not rnmedanyuf the waste desolbed abonea%sth ar7otherrhazafdafss Wyse{•,the total halide content is GREATER than 1,000 print,and the waste does not Contain any Kill.I Voveprwiderlprtlasf perdinep1►t14n lOYHtt11F411 E!wlmnrYtenLeF$ctrkeS.tc rebut thO IsWu npth7n that this waste was mixed with other hazardous waste.I agree to accept the additional kharges for the disposal or this.: , wast!If the Inforptatron I haue provider!aLwssushls.swtteIssrscaflect,:th.:y. .. .. - =e317hls wauc is from atank whkA'ca}facis waite 911 irctri hnusch'old'•d7-ISlydursglf'(f]If}Alsifjar eusrdhFinally c,.crnpl srsia ll quantty gerrosaiar,ICESQGI sources.'ro the best of my kwwledr�:{hednlywasfilali wntalnnl• In'n'�f]IYlCESIIGeollacaorii64iswfcyfrom.01Y.-%WoiLLSgGsuluCAthovonpimlll I''M&w4stekiltiAjhanyotherhaiardautviasleofwaitaolIfromaihorsouice:.lagieetoacceptlhcAd_diiionAtN�rgeSf idispnial - Vrthls wasre tithe anfonnaton tune lirstvidcd abaue this auasta is InCPrrtti � ' (All generators/customers MUST read the following text and check the associated box.) �1!26 ma3eogram in plats to reduce Iho,valumeand tflkkrsy ory ossa genefascd to she deryreo-1 kava determined to Ise ceonomlcalry piaci{cable and dies I kava the prxticable method of triaifr1,e11t,sletagSgr4400%hl r:wrs:+ttly aw the 10 nlewhich minftr;:WthC present and fusum Ihrnal to IlLhuri illi and tha enirronment:C,tr I am a srtraq gwnolygansiralor,I ea g:W faith effort so mrnlmin my wastcgerieratltrf and srlecs the fiisl rrfuthr'd thA tt availawt to me shat I can rlford, - {hy Irsdiv dv�slginieq In the space set forth below on behalf of Customer roprcienis and warrants that he/she fins the authority to bind Customer•that the forgoing descriptions of waste and materials re true and accurate as px L arked and labeled,are ready for transportation In accordance with applicable:tate and federal fegulatluns,and that Cusco shall ahlde and be bound by the StandardTcrms and Conditlons an the teyerse blOral chi AW ce(hder. - Cusco a Sig re Dote � 9 Driver 5ignat r Date Print Name Print Drivers Name