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0 ,S V[GE CALL: SERVICE ORDER �OIV OFFICE ASBURY.ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-B (4117) 1-8007727-2879 1A10 850 SERVICE ORDER NO. FOR ACCOUNTING CALL: WODIY 0 562-231-1550. N2525808 AI= 1Z3. WORLD 01,L, ENVIRONMENTAL SERVICES,. S STOGICTON D7C5GE INC 7300 CHEVRON WAY,DIXON CA 95.620 H 1-800-727-2879 PP 3333AUTO CENTER CIRCLE WWW.WORLDOILCORP.'COM PO BOX 8008 E T STOCKTON, CA 95212 TRANSPORTER EPA#CAb028277036 STOCKTON, CA.95208 0 [208)477 3880 (208)477-SM CUSTOMER It PURCHASE ORDER# ROUTE# TR.UCK# CONTACT NAME ORDERTAKEN BY HALIDES STO827 ER-Bg 1OHN STANTON avelanuex, J DATE REQUIRED \ DATE ENTERED NEXT SERVICE D TE CUSTOMER EPA# BILL of LADING/MANIFEST#" 2115/2018 CAD981887eW PART#' DESCRIPTION QTY UNIT PRICE • QTY P/U• TOTAL OF USED METAL OIL AND GASOLINE FILTERS 1 $55,08: $55.00 ❑FDR '. OIL.FILTER IJRUAA REPLACEMENT. NO CHARGE i' 80,00 � ' $0.00 . BATt�4� '.e_ • C l'3et lgnatur�fiorn .r°•asy. I TOTAL CASH REC'Q,.1. CHECK# Amvunt 1"napr.SW*(M*- WASTE DISPOSAL 013M NON.-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXI=D'OILS)' STATE CODE 22 NON=RCRA HAZARDOUS WASTE,LIQUID(ETHYLEN.E GLYCOL SOLUTIONS) - STATE CODE OTHER: —NOWRCRA HAMDCd)SWA5TErSOLID.(F•ILTEkB•COMPAINO A" •N)SST s�--..►`^D -.- DESIGNATEOTSDT:y1PkiA14�YES ALTI RNATETSDE: DRUMS P/U: EMPTY DRUMS: FACILITY: _ BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) Ly signing below I hereby certify than: - (Waste oil generator/customer MUST check ONE of the following three.boxes) CU 11 l have not nilxed any or the w.iste described above w4h any othivr hazardous waste the total halide content lS LESS than'1,000 pprn,agd the wastadoes rwt cvrnaln arry!'t:8s.I hate cnmpllcd with the!ec ulmments of the applicable California used oil management"ulations to determine this Is true.I agree to accept the additional charges for thedlspasal of Ihly waste If the Infon wnton I love provI*d about this waste Is In{oreect OB2(have not mixed anyof the waste described above with any other hazardous waste,the total hallde content Is GAW111i than 1.000 plans,and the waste does no;contain any PCBs.I rove provlded propwr darumental{on tovlarld oil Environmental Services m to rebut thet re,upl ldn that this waste was mixed with othef huordous waile,I agree to accept the additional charges for the disposalthi of s wasloIfthe lnlnrrnauonIhavdprnvldCd;bowl this waste ls+rKorrgt 0#]3Thiswm,6Isfrornatank which collect~wastedlfrom fsbuxlsuld'dait•yourirll'(OlY)andciis rtdidonapyexemptsma@quantI"g neraror(CES°GJs%rrces.Tothe best ofmyl'naval ledge,theonlywealeontalned inmytijel CSQGcollectionrankis'soleyfromOlYand/orMCIGsources.Ihave not inked this wasteoil'with any otherhararrlouawasteorwatseoil fromatheisources.Iaryee.lometartheadditionalcharr, 0ofdltpo1al of this vra;te if the Inrormadon 1 hope provided about this yiatle Is Incurrect [All c�eneratarsl customers MU5T read the following text and check the associated box,). d4!If I and a L9rgrquarrutygcrrrrotar,!cut•ly:hal I have a prvgrarn in pRuc to rcdrsce the uolurtsc and toslctty of.vaslcticaicraled to Lha ric�scc I timedotermincd tri be lrle arul Ni.l h7vse refer ed Urepr xflCalle ma[hnd of utalm�nL slwagu,ar d pawl current y avail btu rpn a which n nlmisrsnc�•Irs�r m and Ions a rfieat In hvmalrerre and Itu'trmlfonnrent;Or,Wam s%twit gsunlity gerserator.I ve ntsdc a rJood IaVlh effort to min3rnl ra my wasi9gtlnrr,stlr>n and resect the hrss~Otto management mef hrsd that Ys avatlaklle to me that 1 con afford. - T}r nsdivldval s;gninr}In the spxa scl[ortls below an 4nhnlf of Gsrs:vmor feprc:erts arsd warrants that hclshe hos t1+e aulhorlty la bhsd Cusurmcr,that the forgoing dascrlptwnsafwancam$materials are true and accutatc a:paLkage[I, and kbeicd,are ecady far tiansparratfon in accordance~lilt appllea3sle stain and federal rrgulaHtrns,and Shat Caf:tORrer:hA abide and be bound hythe Standard Terms arW Cm�dltf fir ;rs �s 5i vile tiler- - 1 �" ��/ Cusco ignature Bare !!!!/ Drip 5ignalur F I Print Name l f Print Df;,GCrs Narne