Laserfiche WebLink
SERVICE ORDER <br /> FOR.SEFtVICE CALL: N. <br /> PAAbER i ASEiURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOE5004-D (1/17) <br /> 559-498=0240 stip SERVICE ORDER NO: <br /> FOR ACCOUNTING CALL: WC}DIY'0 <br /> 562-231-155Q. N2647403 <br /> AF 125 <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,M <br /> H STOCKTON DOGE INC. �:;_ 14287 EAST MANNING AVE,PARLIER CA 93648 <br /> ,p3 AUT()CENTER GIRCLEt• 1-559=498-0240 PO BOX 8009 <br /> P WWW:WONLD01LCOFIRCOM <br /> STOCKTON,CA'95212 TRANSPORTER EPA#CAD028277636 STOCK'fON, CA 95208 <br /> T (209) 477.38W (209)'477-3WQ <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN"BY HALIDES <br /> 14TO62,7 R )UTE 124 �fj'+.� SCHEdUI.ED-I <br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE" CUSTOMER EPA# BILL of LAOIN6/MANIFEST H <br /> 413nQ18 3127('210�,$I CAD881997880 d .1111:�� IJ . <br /> PART# DESCRIPTION QTY UNIT PRICE QTY P/LI TOTAL• <br /> wo USED OILI•MIXED OILS. 445910.00. l�Q $0.00 <br /> WO�C USED OIL SERViCE,CHARGE 4 �So,00 3$0.� <br /> BATCH it <br /> Cio Sir+dift Got sfgrmtu ra from Caay.' TOTAL <br /> r <br /> CASI•I REC'D' CHECK# Aacowt Manager Sto"00* <br /> WASTE DISPOSAL INFORMATION <br /> NO11.8CRA HAZARDOUS WASTE,LIQUID.(USED OILINdXED 01L5) STATE CODE.221- <br /> NON-RCRA HAZARDOUS WASTE,LIQg1D.(ETHYLENE'GLYCOL SOLUTIONS) STATE CODS - <br /> OTHER. <br /> +, DESIGNATi DTSDF: <br /> �k:iBtfftlf-FsNVlfii"3FF11�B4Fff�81:rNI��E1tE�;'t�Z'Q'AtQIR�i•it�I?e�[�ro696�{�]F++{7=I�;�AF,A�i36►��7 I <br /> ALTERNATE TSDF: <br /> DRUMS PIU: EMPTY DRUMS: FACILITY: BSC ) <br /> GENERATOR WASTE CERTIFICA-nON(PLEASE CH ECK THE APPROPRIATE BOX) <br /> Btl sM�nlnq beltrw k ncraLsy cnury slur. ., <br /> (Waste-oil generator/customer MUST check-ONE of the following three boxes) k <br /> I=r ll l pm"!,n,I rmmid osyr of tw wtm%e dexnhcd above heithortp other blauclam wast r,the.soiil hitidc cpnttil l It Ms than 1.00(7 pprn and the witswdort nue:"n n any PC4s.I hasecomplfad with she reguiremi;r?ss of <br /> ow Piudlcah:e Callfunla sh <br /> red Wmeovrnerss ttguint,orss to determine.t1th is tour. xp <br /> .I ca to accept the addidonal chu"s for shv ditpusal of thhwmtr it the iarnrrnadan I havepmvrded k6ytlhsmailc Ii Incorrrtit• . <br /> III h"r.notmin ed,Any ofthe wasteiletuitudaboWwithartyother haaardpuswaste,tilt totalhalldecontent isGRN ER than 1,000 ppm.)rid Ole wastedoe snot conraahanyPCBs.I . <br /> haveprovWed ptc4mdommenwWpto}vt+tWOil Fhv,onnjch%4*'s'l5as.torabbi,the pfi"umptionthatibiswaste was otixtdwith other luumdou;Tvmte.Iagree toaterpllheaddfdonalcharges rodthe,disposal ol,ihls•, <br /> eivaatte if the wrormafian 1 have pr ivrde![a>vui thli wasto.lS ncwrcat <br /> pr3]Thls wase h irc•m a lankbA IeH WILKis wam oll from hlnsichcld'de•ii-yowso.I"(DIY)and/or eoriditionally.ummpe snub quantity genem[nr IDEM toZ?tes•To the best of ssvyimowledge.the unlywii,"olfcoiitd�ed <br /> tr req 61y1i E543G cotlecd6ri laak is salpy from 1}1y andlru CE50G iduir ra r hive.iiot mixed this%03tenll with any dtfivi hxs1+dous ivaslr or waste oil(rpm other sourcm.l agicr ipatrept the additional chargeti foi dlippial <br /> or this wash it she.informal loft I hwo;xevlded about this walla Is Incorrect - <br /> (AII generators/customers MUST read the fallowing text and check the associated box.) <br /> CI941 It I am a'.lr Je gtlaTiley generato,t[erldyf 17ti haVC7 program Ia jlja[e t7 rrdt[C thrvpllim@ and loxlClly❑f,wasje generated to It edr,ym I flaw Hotel mined to be ecoanrt,ically praetieableand that I have <br /> Wlectied Ne pi acttnbfa rambod of im.)Vvnl,sioragr.elf di>posal cui•renNyavallibW to me.svihlcil minimL44 ihr pre•irni muf future thrNt to lsk4rmn meand the irivirenmrnhCaf Y l am a smA quarsiity gorM+jier;I <br /> hmma rtt a good IMNih effart Iv tnlninsi!r,'rnywssir:genrral[In t Md sele[S the hest waste that Is a,r4lbble m me that 1 eattaffard. <br /> Thls,nd IvW hal s,gning IK the space set forth tw6v ars tloltalf of Customer Irnr L•tenu and viarraintI that helLhe het(the aulhad ly to bled Cusiomrit.that the forgoing desrtlpelam of waste and materials iie 1rye and uctilate <br /> at p44■gNt m6M1 rJ a nd labeled,am wady far tr ansporl-Wo n rn ac cot dance with.1ppl•cab1e:tate and fskml i"ulallon sand that Cuw lame,r shall abide and be bon r Trr, ref Conditions on the reverse <br /> lid('Cif this 5rrvrerWe(.. <br /> 0y, Y,�,/y <br /> nature Date Drier igDate <br /> _ - ►.f1�r <br /> F+ t N Print Drivers Name <br />