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.,,.AQrrSF.fIVICF.,CALL: SERVICE ORDER 51T01V dFFfCE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-B (4/17) 1=800-727-2879 wo 650 SERVICE ORDER NO. 7: FOR,4CCOUNTING CALL: WOC�IY 0 562-�31-1550 N2525604 AF 125 MOLD OIL ENVIRONMENTAL SERVICEStM H STOCKTON DODGE INC 7300 CHEVRON DIXON CA 95620 P 3333 AUTO CENTER CIRCLE WWW.WORLgOILC'ORP.CONI P'BOX W0® E T S'TOCKTON,CA 95212 TRANSPORTER EPA tic CAD028277036 STOCKTON, CA 95208 ° (209) 477-3668 (209)477=3888 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK It CONTACT NAME ORDER TAKEN BY HALIDES ST'C)827 87Z38 IER.86J O.HN STANTON avelazggez i DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUs TOMER EPA# BILL of LADINGNANIFEST Y' 2115J2Q18, CAD981997880 lQ ]. 3"A 2q-z- PART#. DESCRIPTION" QTY UNITPRICE QTYP/.0 'TOTAL 55-01TI41 55 GALLON OIT DRUM(RECONDITIONED) 1 552.00 558.88. OILY SO OILY SOODS PER DRUM 1 $165.00 ( $165.00 BATCH Cro 33,Stmets; TOTAL'., CASH REC'D- CHECK"#_�:_ Aemd Marlow Steve Det N WAStE DISP05AE INFORMATION., f NON-RCRA HAZARDOUS WASTE,LIQUID(USED TOIL/MIXED OILS) STATE CODE 221 NON=RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL.SOLUTIONS) STATE CODE � = OTHER;. - DESIGNATEDTSDF: - ALTERNATETSDF: f DRUMS P.IU:_._ EMPTY DRUMS: FACILITY: BSC GENERATORWASTE CERTIFICATION(PLEASE CHECKTFIE APPROPRIATE BOX) By signing below I hereby certify that: - (Waste oil generator%customer'MUST check ONE of the following three boxes) r—:::]al)I have not mixed any of thewasu descflhed iho' with any other liarardous waste,[fie total halide content is LESS than 1.'MlOom,and thv waste dves not co nLiinany PCBs.I have complied with the requirement's of ' the applicable California used oil management regulptlons to determine this is true.I agree to accept the additional charges for,the disposal of this waste if the information I have provided about this waste Is incorrect MIR 21 have net mhretl arty Of she WAW descrlbrrl shave with any oiber ha:aidout waste,the[01.11 hillde content Is(iTIFATER Yeas 1.0K ppm,and)hewaste deesnot conlainany PCBs.1 have PrOrklrtl properdocumerst7tlgq Iv World Oil Env BOAllthnl0f set vices to echo[the Pfesunrp[toff that,this waste was i nked wld+other ha:anlous while,lagrcr to artMt the additional charges for the disposal of this w.nte If u�r irstarlwtinn I lsasseprsisrlded afford flirt wakiats incaurel ., .. . . ' 13)tTh Is wasie is from a tank which.rnAccts waste oil from houschvld'do-it-yourself*f ow)and/or conditionally exempt small.quantlly gerxlator(CESOG)sources.To the best of my knowledge,the only wasle oil corltained In my olY/CESQG collection tank is soley from DIY and/or CESQG snurres.I have not mixed this waste oil'with any other havaufrsus waste or wSite oil Flom other sources:/arjrec to uceept the additional charges for dhpbsal of this waste if the information I have provided about this waste is incorrect (AOI generators/customers MUST read the Fallowing text and creek the associated box.) rt)if I am a large quotstity cf+rnewl w.t certify that I hivea p .0 rog+ tl 41 plata hotredu[u Ihr snlu me and was lowi;Ity of te rdenerasrrl to the*gree I have del ermined to be%scormmscalfy p+ac Rc,lhle arnl That I have clefted the practicable tnetFwtf of Irrafnwnr.bkmil,w.or dlsfmsal eunowk0y available tat me which mInlmircs the PnR eat and fulme Ihremt to human life and Sltcaavlrrmnw+Itt N.J1 lam a unall Qwntlty gcnelator,i I. n matica goad talsh plforl le minlmlm my wastu gennatlpn teal retie[the best wastb snanaf}Nmenl nsrtnodllsai Is oraVkahlr ra me/fiat 1 cTn sffvrd. This divN! 3_lra3 In the ipaca set forth below on be of Customer represents and war nla thaT he./she has the authority la/+Ind Custonser,that the forgoing descriptions of wasie and materials aro Irrrr and zrcurate asp. e• eked and Iabelod.are ready for Iransportatlon in accordance wllh appllcahle stale and redaal r4gulaliom,and shit Customer shall ablde and be hound by the StmvLnd Terms and ennditlons on the reverse lem Order. CLItomerSignatur Date Driver Slrgna Date +`rS Print Name Print Drivers Name