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F04ErIVICE CALL: SERVICE ORDER, <br /> PARLIERA$81_113Y ENVIRONMENTAL SERVICES, DBA FORMNO.WOE$004-D (1/17) <br /> 9:7 0240 �- 'r ,r iii.;',> SERT/ICE ORDER NO. <br /> WO 650 <br /> FOR ACCOUNTING CALL: <br /> 562;.231-1550''. WODIY 0 <br /> AF;1,25 <br /> .'WORLD OIL <br /> EN'VIRO'NMENTAL -SERVICES,. <br /> S 14287 EAST MANNING AVE,PARLIER CA-93648 <br /> " •8TOCKTON DODGE INC 1-559-498x0240 <br /> 3333/AUTO Ct NtER CIP,.Ut WWW.WORLDOILCORP.CONI PO BOX 8000:. <br /> p' TRANSPORTER EPA#CAD028277036 <br /> t� srOcKraI�;CA 9521� 9TCyCK7ON, CA 9508 - - <br /> °' (209)477.3608 (209)477-3980 <br /> ,,CUSTOMER-4 PURCHASE ORDER# ROUTE 0 TRUCK# CONTACT NAME ORDERTAKEN BY :HALIDES <br /> STg827 r. R LITE 1.24 .L,(ooll . SCHE©ULED-I <br /> DATE REQUIRED DATE CNTERV NEXT SERVICE DATE CUSTOMER EPA 0 BILL of LADINGIMANIF£5T 0 <br /> ` 1110/2016 . ..1140018, x;.;: -, CADNI W7880 <br /> PART•# DESCRIPTION QTY UNIT.PRICE QTY P/U TOTAL <br /> WOSC USED 011:„SER,VICE PHRGE; f' 1 $80:00 . 3 41 $sa.00 <br /> wo USED 61L I MIXED 668t";:= 380 $0,00 <br /> BATCH <br /> • t'...F _y.;?ti,A�.;'Jie jasit.11l:;f,p w*:+vir'Far L - ,.:•. ., <br /> cr4] �i $eis: 1t Nr:•f 'i;, . TOTAL <br /> CAs;I :JR.•D:. CHECK t— _: Awww*•If+lanalgW'Steve Gately <br /> WASTE DISPOSAL INFORMATION <br /> NON=RCRAHAYARDOUS WASTE,LIQUID(USLD CAL/MIXED OILS) STATE CC)DE 2.21 <br /> NON-RCRA.FIAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE'CODE <br /> OTH1 R:. 1 Pr•;r 1 <br /> 01554NATEb T'SDFt' <br /> ALTERNATETSDF: ASBEIKY- <br /> DRUMS R/U' EMPTY.DRUMS: FACILITY; 85C <br /> GENERATOR WASTE CERTIFICATION(PLEASE,CHECKTHE APPROPRIATE BOX) <br /> Dy:Ipnlnp holow I hcrehycenify sitar: <br /> (Waste oil generator/customer-MUST check ONE of the following three boxes) <br /> �)I h lvq Flat nrMldZIN of lhRwditc llel0bttd above WA any uthcrfia:>Rrdous waste.She 190hpfIdo Content Is LE than f,0o0 ppr t ontl she waste does not Can any tsCyi S have compered with thg leglsl onrcnis of <br /> shn applKatrle[ahfnrnia iced oiimnrw[lerr entregulArlensto detutrnlne Ihisls tris0.l aunts loxcept IIseaddlslorsal cltarpus[or thr dbpowl of this wasle If INIrrrofrmation I ImW provided about Ibis waste Is Ineoerect <br /> IMis2tkava not nticod airy 6f the wsate desn fbnd abova with any other hazardous waste,the total halide coment is GREATER than 1,000ppm,and the waste does not contain any PClss.l ' � - <br /> have provlded,praper documenlatlgn to.WMk1.011 Frnlr„ )a!Spr*ps.to rebus thapresumpllon that this waste was mbsed tvio other hazardous waste.l agree to accept the additforwl charges for the cuiposal of this. <br /> wale}(lhglnlnmsulionl have 7Nlarldcsl•a�rvul tlys wdir�itcprlaCl• .. � �•• � � � <br /> lir]ITnn+viskeIsfror'asankrvhlclrCvl![nivaslcudffft7i hr stiediultlskhyndrsetf'tp{Yland/or cBndllionpllXerrArpS►mollgondlltygcheratut(CE5QG)!.ourscs.Tothebet ofmyknrnvledgc;Wevnly.Wamvopcontained <br /> ire m1i fAYf t{` C:•rllectron 4anit 4 sofey fr on%MY amlloi CEWG so'usUs:i havt np[coifed thls,watc till s'vllh,dny other harardous wa lle'oi wase oil from other"'tikes.1 a'grea.to accept mt'440lorsal charge's fDr tlispaiSl <br /> of dill waste if the information I have provided about this waste Is incorrect <br /> (All generators/customers MUST read the following text and check the associated box.) <br /> at If I+m a 41x94 y,lantity generator,I certify lhaT 1 have u proquTrs in pNxe ro reduce rhe volume and to+leply or waste generated to thk degree I lovir descr.nincd to be"un o mieally PUKflUtrlt and Ihat I Have <br /> r sefsdted I}M prar.ticalde nrrtlivd of titatrheril,sfoiiye;or dtl;iU4jrCyriren1y avvi3oble to me which Plotdmiurs the presemtand Jotuie TNr al to hdman 11 in and,;is envlrunrneiit;Or,If I rim a srsull:iudraily generator;I' <br /> km TnAtle a avlxl Will efrari tss mJi;imin:irry wa iu yniersl+oi+.+rirl solcwr ihrr b>i-sr w a e marup,vn'ent tn'ttTad than lr aval lnble to me thui 1 can alfnid: <br /> Tldt individual signing in the space setfonh belorw on behalf of Customer represents and warrants that he/she has the authority to bind Customer,that the forgcing descriptions of waste and materials are uun arsrl accurate <br /> ►age ,marked and labeled,are i for transportation in adordance with applicable state and federal regulations,and that Customer shall chide and be bound by file standardTerms,m:l Condtlions on r}re teverse <br /> s 1a flhi:s vlCe Order. <br /> r <br /> C stanlyr Lgnyture ry Date Driver SSiignature--J'�� �� 1 Date <br /> S <br /> Print Name Print Drivers Name <br />