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FOR SERVICI=CALL: SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO,WOES004-D (1/17) ,. 559-498 0240 SERVICE ORDER NO. VVC)65CX , ..FOR ACCOUNTING CALL: 5$2=231-1550 WOOIY Q' AF 105 WORLD OIL ENVIRONMENTAL SERVICES,. s 14287 EAST MANNING AVE,PARLIER CA 93648 M... STOC:I TON DODGE INC 1-559 498 0240 p3n3 RIJl Ci.CENTER CIRCLE WWW,WpRLDOILCORPCOM PO BOX 8009 TRANSPORTER EPA#CAD028277036 ..ro.. ' Si C]CKTQN;GA 95217 •, STC)CKTON,CA 95208 (209)477.3888 (2PP) 477-3668' . CUSTOMER# PURCHASE ORDER#. ROUTE# TRUCK# CONTACT NAME ORDERTAKEN BY HALIDES S7[7Ei27 R )UTE 124 P.. SCHEDULED, ' DATE REQUIRED DATE ENTERED-1 NEXT SERVICE DATE CUSTOMER EPA 11 BILLof LAPING(MAN!FEST# 1. 121290.17 1?J291201, •:. CAD9819B7$80;: b 1"g 2,377, PART# DESCRIPTION QTY UNIT.-PRICE" -,QTY P/U TOW WQ USED Olt-1:MIX90•L�[#�S':.' 380:;. ..$0:00 T34 $0:00 WOSC - USED OIC-SERVICE CHARGE 1 8D.00 $aa.QO Cro TOTAL. 'CASH•REC`D: CHECK#.' - AawuhtMgfta .'SieVet , WASTE QISPbSAL 1iVE013MATiCIN.:'. NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIILIMIXED.01tS) STATE CODE 221 h OWACRA HAZARDOUS WA5TE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE t' OTHER: C7ESiGNATED TS DF: ALTERNATETSD.F: O A VIES-CERES; MO RD„GER 5,CA fib tZ68) -1fI ,CAL{H?63838 0 DRUMS P/U: EMPTY DRUMS: " FACILITY: $SC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) Ry soiny b0ow I hro by cerNty that: . (Waste oil generator/customer MUST.check ONE of the,foilowing three boxes) roti mixedany of the Waite 41010bed above with any wIicrharardnus waste,thit tWIrl halkic emnient It LE55than t.068Irpn4 aril the wastedunsnotcahtain any PCR%I iio-m compliedwi th the requlremenis of She appllrabkt CallfamI4 usod oG rnansyoment ro!Jularionx w detrrmllw this Is It uc-I aiJrre to at[ept th¢aeGlltl¢nal[horge s Ipr the d]iTw5.11 of Shia wa st¢Il th c inrmmatio n I have provirk d a bout this waste Is incen ect E.Z1171 havr not mixed any of thtr waste clewitscd abovrw.lh any atlxrhirarllauswastw,tltr tmW haVde content 11GRATER than 1,060 ppn w d she waste does not contain any PCBs.I hive prcMdcd proper ducumeni ation to worldoa Envl ronmen Wl Set vkes.la+rime tfm pteiumplfop ttwt t hfa w.tste was n"wll h ut hes haiartlous wwr,l eyrea to'neeept the additional char9cs for the dh powl of this waste gIPm iMornt ition Ihow pruyWM ALKMI Ids wnste is 14 IL1sFFCVt - -• • '" M13)TMi waleeis,f{o+n a iankwhlch colfects waste oil lrom huasrltald'i1o•ipyaufsnif'{(]r{}an Orr comrom+ally ejetnpt[mall rluamilyyerioraior,K150Glwurces.To il+e t><st of mykrytwAt•dijc,iheti*wmI't9:lcontaineo N ray dlrl CESOG colkeion rank u farcy ham D1YartdlorCES6G srwrces.l have noT rr,rtLil INDw i%t,nal wish any othm ha:udwis w.sstem.rwayte nq frcmtulfiri s .0 res.iagmp Ta accept the addhinrnT ctwr t.fnr-Iltpp}vl of Shli waste if the 4nftNmation I have provided about this wa 1!o is InwmtGt ter. (Ail generators/customers MUST read the following text and check the associated boxy Y !afi A laryrryuanuty generator.I certify shw I Nana p"nert In place to+edumr the Volume and to.ic Ify of wa;tr generated to the dgwv I havq de termined to br wconomknily prat ikabie an:f that I have ulenrd the pracikshl4 hutlsvd o!urutmrn4 siwar�w,or W%p"cun:nty ay;iiiab;c to ri%r vihicNrhlnlmfie;,the present aril fuhim threat to INu i liars life afrd ihb envirunmmn;Or,If Lim a v4ail gtLUJIty.gen[raior.L, , have nsadr a good raltk offort to minimirr my wasto garoratign ano Inert thr.betii warm 6;ki ageinrnemrihtid that Is ara}lable iv rnn thit I can atfmO. This individual slgning In the space set for ih below on hwNIf of CYtltwr repsc u!his and A%1Ftih15 Iftal iW3410 hu t}i¢apihprl ty la bind Customer,that the Its rgo4ng descriptlons of waste and materials are true and accurate aspackaged,markedand laWM,are ready fwiraotportation16necwdalxuwithappllcablesialeandflrirralrugoautsm.anclNit Cuuomof41AIIa he bound by the Stand and Terms and Conditions,anlhp,r_er;e side of this Servlce Order. /�C.Stcmer iofla ateIgnature Date -- rint Name Print Drivers Name