|
JF_Q9.sIR.RVICE CALL: SERVICE ORDER
<br /> PARLIER ASBURY ENVIRO MENYXI_ SERVICES, DBA FORM NO.INOES004-D,(1/17)
<br /> 559-498-0240. WO 6E�0 wI. SERVICE ORDER NO.
<br /> FOR ACCOUNTING CALL•VVODIY 0 N236807�4
<br /> 562-23T=1550 `'
<br /> :�•;. RF 125 ��r`/�] OIL'. ' . .
<br /> ■■
<br /> r 7 S4 V R L® O I Yom'
<br /> -ENVIRONMENTAL SERVICES,.
<br /> s $:r0CK 0N-DQ1)GE INC 14287 EAST MANNING AVE,PARLIER-CA 93648
<br /> li 3333 AUTO CE=N tR CIRCLE PO BOX 8009
<br /> P
<br /> P WMMORLDOILCOOP.COM'
<br /> D D.STO( FCO ,CrA,95212 TRANSPORTER EPA#CA 21708
<br /> STOCK ON% CA 8520$:
<br /> T {209]477-3688 (208} 47,7-368$:.
<br /> C:U�TOMER 4 PURCHASE ORDER#, HOW E# TRUCK CONTACT NAME ORDER TAKEN BY HALIDES
<br /> slutre/ 1:24
<br /> I
<br /> DATE REOUIRED DATE ENTERED NEXT SIERVICE DATE CUSibMER EMU SILL of LA])[NG1MANIFEST l
<br /> nj
<br /> PART kf. DESCRIPTION QTY LIN1T PRICE; QTYpIu: : TOTAL
<br /> QSi�o OIL I MIEO OILS - =00 $0.00
<br /> ou
<br /> BATCH W ,
<br /> . r
<br /> Cras Streem:
<br /> TQTA'L:
<br /> CASH RECrD' CHECK#.
<br /> WASM DISPOSAL INFORMATION''
<br /> NON-RCRA HAZARDOU$WASTE,LIQUID(USED OIUMIXED.OILS), STATE'CODE'321
<br /> : NON•RCRA HAZARDOUS WMSTE,LIQUID(ET'MYLENE GLYCOL SOWTICIVS] STATE CODE r'd;rr.,..., ..:,•i.: .
<br /> Xj OTHER:.
<br /> DESIGNAT[[7T k7F; ASEtL1R RONHlENfr41 S R lICE�CERES,182q MORGIM RD.,CERE9,CA 88359 209}5111-1W;CALQW3
<br /> AUrERNATETSDF;
<br /> DROM5.0/U: _ _ EMPTY DRUMS;, FACILITY: BSC.
<br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX)
<br /> Ry signing bdoty I hereby eertify.thau
<br /> r r (Waste nil generator/customer MUST check ONE of the fof}owirIg three boxes)
<br /> ,1131 has•e nnl miveil any of Ihttwasle citscribed%Jx r with.n+y other hu1.1rdas+s wasirr.the folnl halide content h L"r'than i.M17 ppm and the waste dost'nut[ontaln any rUkl havw complied with the requlfements of
<br /> I .agplkable Cahlonsla tried oft mawgumanl requlatlont to rhttemslnn IN&h true I aryce to accept ihe.sddihonal timrges for it*dhpos,it c f this wa"v If the inferntallan I have prosrfded about this waste Is Incorrect
<br /> -Ma2 hoetwtrnhcdnnyolt"rraxedesvlhedrovewith atsyother•hazaidowrush,timwlalllahdecon tont isCREATE.R1IL+nI,0Wppm,arid thewastedocsnot camel"anyPCRsJ
<br /> 1ww JxrrALI td its gper doe or rd nt a I co.l o wadd 611 E ny urnmental icru lues tr1-rubui lht this wa sip pea t m ked,vlth otlmr harodou s wal te-I.aprce t o ai:96pi the additional ch,p yes for Use dlipowl of this
<br /> V mw-li She tniormatitxt 1 baro prrnVegLabout thiI war to Is Incoroec:
<br /> �!1r3i tiara wandls bomb fartll wlq[h[o71cCu:wssle oil frrir?thaasuhold'[lo,ll•ydslrtell'(DIYJ;nd/or[m+dn7owlly exempt smaq quantify ilenurater.lCESgGJ tpd[cs.lo the bine of my knowhslgc,the only wash oil catlsbMcd
<br /> Irk my DIY!CEsq[;'tolti,etiati sunk a inky from QiY w dlar CES01 iourebs.I have Rdt ml.ed this waste all valh any 01110 hazaKt vs was 1e or vwsl coil Irgdinher souiees.I agree Lo'accepl the idditlomil charges for cliaposal
<br /> via rlt sva sti-ri the iolorrswtwn I hm prwwod atwut this--ter is Wvftoct
<br /> (AIl generators/custorners,MUST(read.the following text and check the associated box.),
<br /> a•sJ lI t am a Large riligatll y genural W.1 car tilt'that I have a Jnoomm in ptace to raster I he+lulsrinr will ta.Idsy o f wa s to gs nems d to the len rer I have Ile l er mined to be econtftnkally$vietls oWe and that I NAV
<br /> els4led she prnc tlta7rle mnslted til srratrrrem,sxwage,or disposal ctmcnllynva1lati1a to rnewhich rnlnituues the pr¢srnt and future IheeM'te itulman We and the cnvuarnnenl:pr.U I meta small quantity quainter;I
<br /> h, made a good fhilh effort m mniimlcr my Wsstegrncratton and uien the thnst waste management nsethod that is ival AW britt-that I Kan afford,
<br /> This Iriih dualWnth, 1,o,,1,hb,,1,,wo�1w on behalf of Customer represents and warrants that he/she has the authority to b"id Customer,diet the fotgolng descriptions of waste and materials arc Irue and accurate
<br /> rsrnrlC agnd,nta++pnrsction inaccortlance with applicableswte and federal regulations,and thatCustofner shAabidrand brbeund by the StandardTerms and Conthionsrm the reverse
<br /> ti
<br /> rner it ature Gate ver S1 tore Date
<br /> Print Name Print.Dr vers Name
<br />
|