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SERVICE ORDER
<br /> FOR SERVICE,CALL:
<br /> PARUER ASBUF1Y ENVIRONME:NT4� SERVICES, DBA FORM NO.WOESoo4 D (1/17)
<br /> 559-498-0240 WO 650 SERVICE ORDER NO,
<br /> FibR ACCOLy111TING CALL:WOOZY 0 N23827$2
<br /> AF 125
<br /> WORLD 01L
<br /> ENVIRONMENTAL SERVICES,.
<br /> H STOCKTOti QOt7GE'ING 14287 EAST MANNING AVE,PARLIER CA 93648
<br /> r 33 3 AUTO CENTER CIRCLE1-559-498-0240,. P© BOX 8009
<br /> P WWW.WORLDOIL.CORRCOM
<br /> E
<br /> STOCKTON.CA 952.12 TRANSPORTER EPA#CAD028277636 STOCKTON, CA 05208
<br /> o .(20 )q77-3688 (2=477-366S
<br /> CUSTOMER# PURCHASE ORDER IJ ROUTE#- RUCK# 'CONTAtTKAME ORDER TAKEN BY HALIDES
<br /> STO627 124. js�rltOn,
<br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA'# RILL of:LADIN(VMANIFEST 4
<br /> 51212017 CAI798?997
<br /> PART-# DESCRI"ON QTY UNIT'PRICE QTY P/U, TOTAL
<br /> AE ETMYLI�NE QL Y00L.SOLUTIONS e2 L550.00
<br /> EIA7CH
<br /> i` .Cros �u`17B8tS: r:. TOTAL
<br /> CASH REC'Q:-' CHECK#
<br /> WASTE OISPDSAL.INPOAMATION .'
<br /> NONt RCRA HAZAADQUS WA9TE,LIQUID(USED OIL/MIxEb OILS) 5TATE CODE 221 i,
<br /> NON-AckA HAZARODUS WASTE,LIQUID{ETHYLENE'GLYCOL SOLUTIONS) .:', ..;:; STATE CQOE,
<br /> OTHER:
<br /> DESIGNATEDTSDF :I.:�..
<br /> A.z�L11rl t Mft4llid4 tPrA4.S6f tLGf��-C. R1 tO . . q6 1:iB I Gi4d,QQ6 B 1
<br /> A'ETERNATE TSDF:
<br /> DRUMS PRf: EMPTY DRUMS: FAGLITI-. ESC
<br /> GENERATOR WASTE CERTIFICATION'(PLEASE CHECK THEA PPROPRIATE BOX)
<br /> By signing belo•,v I hewby certify thit:
<br /> (Waste ail generator/customer MUST check ONE of the following three boxes)
<br /> tlIllirNkl{!•not nd„ell any of dsr wutS xfcsGlllsrd aliavv vA1Is anyallutIse r:.,drltls wailq ihk•snldihafklu[trnten[Is LESSItson],=ppm;avid the wastetNtzsnal contnin arty PCBs.I hast!compllec with theiequaemolls ul
<br /> +�+ ,eapoGr,+ble Cahifct,Ha used ail manjryclnpnLroJulations so din&rnInq lhis k true i agrau to accept tMsaddithonal'chargFs for the disposal of lbls viaste if the.lnforrnttion l have provldttl abou:thh vasue is lnrdrrecI
<br /> Imo+;f hs•,v nol mlrrd atyof the v,Alle dascribcd allow M{III arty other hazardaus mattm the:oral halide content Is GREKrfk lliah l,ggp ppsn,aMd thawmle doasnor contain any 11COs.I
<br /> have prpvifed prolrer.W Kurmmlaunn,tu NSsrld Oil Eisvl+6suurmsaf 5tiivia•s to retia[IN-pi ewmptWn that this w.Wc Was rtslaed with othgr h azzirdom%rile.1.191 ee to.Inept the addiliolul chauies fol thr rJhpnsvl of ihh
<br /> watts if the adi ntatiws 1 hAve pwv de d Ghoul IhtS wnsleli fmm�ecl
<br /> i
<br /> 14whill WAItels frofsy i mok whrchiollrzts wat[o oil Irmo enmpt imll quanoiy gcricritorlCE5401 wdzcn.l'd the best of nny knowltilge•the only waste oil ibritaltied
<br /> inmy6YfeT qGco1lmIorttMr1111-.0eyf+tmnDfYarlror,CE5tKsofuees,lhavenotmixedthiswashdiwithanyblhCtesa+6rdotiiwfsle,d(swasle'etffrumoillersourres:1.19reetoarct,p6headdilionalchao.josfordlsNQI
<br /> of this 1"I ve 9tin lnrorrrWinn l h.rvepresal6d About this wash is lnemtnl '
<br /> (All generators/cus.tlarrters MUST read the fo9owing text and cheek the associated box,)• � '
<br /> ,I d•S)II t am'�,large quantity rjVnrfal oi,h eCnHy Ilial I have t"barn In plao m roducC the volume.and.lorrLJly o'f Wd3l@c]cnprattd to INC dCfjMQI hart dptefmfned 1p lit oCAnonllCJlly plxlicathe ind that 1 have
<br /> l �hti--d the practicable rnerl'u.1 0 ttcasmona stwacle,or dl•gwxdl,cwmettly.4"lahle to me%hrdi n1inImton Ili*is"SentAnd fWurelitQAl to human lilearld llic eu.•t+onsssc+sr,or,it I asn a.matl[Iuantity generator,l
<br /> have made:+good faith epos:to minimize my wawa generoliols and se.iW the best waste management method that Is avallable lo-me lh,10 can afford
<br /> This individual signing In the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer,that the foigoing descopllont of waste and mate:lals ma,; rsd-wturato
<br /> ss pscktrr}s,t1 n+ar s. Arts:T.11[101! arc t•11Y for transparsslinri in accordance with applicable state and federal regulations,and that Customer shall ablde and be bound by the Standard Teens int:credit• on the,o,v,w
<br /> rsidc of hist.tree• sfer I '
<br /> t
<br /> Vit:_ _ _ _ _ 77
<br /> C'ustarner Si�j �rture Date Drive �nd if� /, �e r
<br /> Print Nalre Print Drivers Name
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