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FOR SERVICE CALL: SERVICE ORDER
<br /> PARLIER _ ASBURY ENVIRONMENTAI:'SERVICE:S, DBA FORM NO.WOES004-D (1/17)
<br /> 559-498--0240 WO 550 h SERVICE ORDER NO.
<br /> FOR.ACCOUNTING CALLL:W0[)IY 0: I,123$177g. R
<br /> 562-231-1550. AI= 125
<br /> h,
<br /> .:- WORLD OIL - -,
<br /> ENVIRONMENTAL SERVICES71
<br /> s STOCKTON DODGE.INC 14287'EAST MANNING AVE,PARLIER CA•93"&
<br /> H 33,13'AUTO CENTER CIRCLE 1-559-08-0240 . PSC?BOX 8009
<br /> p WWW:WORI_DOILCORPCOM
<br /> 0 STOCKY'ON,CA 95212TRANSP6137ER EP - " STOCKTON,,cA 95208
<br /> A#CAD02:2i'36
<br /> o (209)'477,1W - F2.091477-3888
<br /> CUSTOMER# PURCHASE ORDER# ROWE 0 TRUCK# CONTACT NAME ORDER TAKEN BY H'ALIDES'
<br /> sTOf327 14 CHEDuLD-4
<br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATE C051fOMERVA 4 BILL of LADINCdMANIFEsT 9 .
<br /> �f2/'?QV. 512!2017 �RC}981.98788C1. / �
<br /> BART#'. DESCRIPTION QTY UNIT PRICE C2TY.PILI. TOTAL
<br /> WO: USED 011,/:MIXC-D OILS $0.00 $0.00.• '
<br /> wosc us5c) biCsr=RVlGECHIARCr' • . :: 1 $8'Q.00; . $8(}.00
<br /> BATCH# '
<br /> ',ct• J. .
<br /> 1'6TAL
<br /> CASH.REC'D:• CHECK If
<br /> ,.,WA TE bisPdSAL INIFaAM&IOry
<br /> NON-RCRA HAZARDOUS WASYE,u6uld(USED 0'ILIIv11XED OIL'S}: STATE CODE 221 2.
<br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENEGLYCOL ELUTIONS) ;.` ;° STATE CODE rr.:
<br /> OTHER:.: ;
<br /> DESIGNATED TSDF:-Asa 16e-Y-EMARObtdRrra� ._..ci r �r� F.»t~!� Ts p Vis.CA 9059( 1C i�I S,CgLtIQ{13�3584;"
<br /> ALTERNATE TSDF;
<br /> DRUMS P/U: ' _ EMPTY.DRUMS: FACILITY:.— -_ BSC
<br /> GENERATOR WASTECERTIFICATIO.N(PLEASE CHECK THE APPROPRIATE BOX)
<br /> iiyszdmngLelrwlhetrtryccr[irythat� ,
<br /> (Waste oil generator/customer MUST check ONE of the following three boxes)
<br /> 1trliaw not mtsctl.aliy of[hr ivt%Il•SLncribed dl1pYC with any gih¢'r hafafdoUi 4Y,i31�,the Splal'haplte Canl�nl!!Lfi S5 than"! ppnL Shd!It[waSle doer[less ttlnlaln any f'(f15 Ila�Y'coniplled riIIIt the IMIUilemCnls of
<br /> 11 clstilfSal+leCahfrrrtsNusodflu m,tri.>,,rarhertt"yAitllortstodcwnionoNiifitue,Ia1mcinAtteptowedmoonaldutgrslot the+llyRnyaiofIhiswalt l04,lnfonrwtlunllu:c Nru:idcd:sbou[thlsw,nlcls.lncot]crt '
<br /> []P7 I Irak Till rWxO any of lho wastd dmal ined abovnfso4th 5rr/auwr harsfdoirs mm to.I 1 korai Halle content Is GREATER thin 1.90fl ypm,and thaLlratte don not con talo any PCU..I
<br /> 1+nve Jimvldrd tgnperdf,currtt•nl$tlpn 1v1Yarld C1il&[vlrugmental servl[cs,lu?ehyttltp plcsumpilon lIw ifll%wbsttr Yr'�S nllaAd Yrlth�]ShCr hazardous mstP•t aUree yp aRept the additional Charges for the disposal of thli'.•,�
<br /> c:asiv d Ihn inrgmwHhcn lin vc pidvl W abarit llih s4rlser is.c I"l;ti -..
<br /> .. .-.r
<br /> M9Wrists waste I1.Gum It taiN which Cully,ti wash<,IT from Intu whoid'do•1l•your self"MM andlor t a4lkrsallyr axergpt IrNa 4111rntiiy.gCtgralorjtEM tout,,%.To the hest of my knowlcdgn,lite.onlyw.Cste oil coniallwil
<br /> hr rnl r!h'f t:F Ni:okf loo Wt is Soley from 01Y andor CESQG tvufcr7.I'liavtr not lNxed thH wasit oilwills,any pdier liS:a]d"lt,3ste eivra%Le to froin ather:bor2"lagree to accept the,tddipgnal tharyP s(or d IW.a!
<br /> e,f thlt,east,.d rhes ntfamalion i Isar p[ot:idarl aWut ihl�WJstt.•h huorrttl " '
<br /> (All generators/customers MUST read.the Fallowing text and check the associated box.1:
<br /> tie)Iftamalargoquantity4toterator,IcrtIIfythalsIsoyrafao{yram place[ureducetheyvfurrl@andlandIyo!wauogeneraiedt9llxdegreeIhavedetermined toheconnondcollyknotIGabIrarldthit
<br /> IhAave
<br /> d Ih':practicable inetbuil bf Ireat,hohl,storage:ordliposal curfanslyayallahlc to ma which mtnfmltrs the prosenEmd future threes to hutnarslife and the r:nNronrtll'nt;or,It f am i vsull yuanuty geritn4te r,I'
<br /> how made o goad faith clfm no minimlre my waw is generatlnn ond,ukct the bom Waste management mslhpd that is oogit ble l o M41hol I cars aSwd
<br /> Thus individual snpdn�In the spate set forth belmv on behalf of Customer represents and warrants that her.he hai the authority to bind Customer,that the forpving desrriplians of waste and m;ii•iiiib we uuc and accurate
<br /> ns pvkwroxnui'kr+ rn! �'l1,ar ready for twiv,pirteslon in.iccordance.with applicable state and federal regolitloni,and that Customer shall abide and be bound by the Standard Term•,and Conddioni on the reverse
<br /> :Ido or this iery n C ,t�
<br /> Customer Signature Date Driv natUreLl Date
<br /> Print Name Print Drivers Nan e
<br />
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