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SERVICE ORDER <br /> FOR SERVICE CALL: <br /> DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-B (1/17) <br /> 1-800-7-ASBURY VVC;65th' SERVICE ORDER,NO. <br /> FOR ACCOUNTING CALL: <br /> VifUDIY 0 <br /> 562-231-4550��a N2369824'• .. <br /> AE 12 <br /> VII0 LD01L . ... .. <br /> E.NVIR:C)NMENTAI_,SERVICESI. <br /> H STOCKTON DODGF- INC 7300 CHEVRON WAY,.DIXON CA 95620 <br /> I T 800-7-ASBURY <br /> p 3333 AUTO CENTER CIRCLE I'o qOx 80019 <br /> E <br /> W W W WORLI�OILOORP.COM <br /> •STOCK'FON, C:A•9.5212' TRANSPORTER EPA#CADo28277036 STOCKTON, CA 99200: <br /> o (W9) 417-3888:• (209)477.3668. • ' lw, <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK f tbNTACT NAME ORDERTAKEN BY '•' HALIDES <br /> S 0627 . � ZACK. awla4quez. <br /> DMEREQUIRE0 DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA 4 BILL.of LADJNG/MANIFEST4 <br /> 8120/2017 GAG]9619876$D <br /> PART# DESCRIPTION Q1 UNIT PRICE- QTY PN. TOTAL <br /> O QFC . OiE.FILTER 013t1M: EPLACEMEN . 2 $0.00 $0.00 <br /> OF lJSEC�METAL-OIL AND OASUk INE FILTERS � $55.00 $140.00 <br /> BATCH 0 <br /> Of streets: TOTAL <br /> CASH R£C'DL .. CHECK II <br /> WASTE DISPOSAL WFORMATiON` . <br /> NON-RCRA HAZARDOUS WASTE,:LIQUID(USED(OItI•MIXED OILS) STATE CODE 221 <br /> NON-RCRA HA7AR(70US;WR57t r LIQUID(ETHYLET4EGLYCOL5OLLniCHVS)• -. STATE CODE. <br /> {3ThlER:• 1�tFIL7ERS OtAI�fINd(�JsAEOS�A�,?33 <br /> E5lGNATEp7SDF: �IAr'� Lt ;�23 , '� 98J. <br /> ALTERNATETSDF: <br /> RR.I}M5'P1LJ: T EM'PTY'DRUM'S; FACILITY:' t B5C' <br /> GENERATOR WASTE CERTIFICATION(PLEASE;CHECKTHE APPROPRIATE BOX). <br /> By slgning below I hereby certify that „ <br /> (Waste oil g�rteratorkust&m a MUBT akk:ONE'of the following three boxes), <br /> L11'11I have net r,tl.ed any of she waste dcstribed above"11II anyother hatatddus Witoe,the wtal Wife cohseht is f,ESS than ix0o ppmt,pr+d the waste daCs nue CnntatA any Kas f[rase Cctntrl6ed with the+.'qu-rcr.rcnh Of <br /> the appliealsle C:illloitsta ukai all l regubtlunc Its dcicrrnfnc this 11.1111e,lapfta to Accept lhcadcittlor of Charges fortlie dttposafo[thh wasit if the Infprmatlod I have pravlded about tlrkl wade it•IflwrrccI <br /> []r31 brit,nes Mlkcvl'Illy Cd the waattridtu+ihud aharo wills Any�l we hazxdttui avle;Ihv tau <br /> t ha?W content Is GREETER slim(.OM Nmt,and.the waste dtn•s rwt cm1aht Any PCaa.I <br /> 11.14apin++kinf pen al?+dn.4lilt'nta tion to t o,hd Gd rRYlrq%6nwm Is!Servlees 16 rebut Ud4p:'su+hjsdon.:f4t t till Iva3td Was mit ed wtlh 0Itr-f ttaaardo*1 tvasfo.l agreC to 7Ccepl die additlasnl charges rof Use dlspo wl of INK <br /> w.4,.if She fnhsrmloh f beer ptnvldee.l about thhiaasse Iv In[tllieet <br /> 1 a31Tft1i'wafle isrrvma SankWifich cnllrctswaftead ffvm h'u5rhuld'e1n il•yuurinlfflDi).audfor CU sdld�stafE'yry6mpt vna11<=uuthy'�anvra[oe IC ESWq tt wrl To Ihu hest ot.nty knawhsdgvfhe 60y wmto Wtontalncd <br /> In my Orr/GESOG cq lCraloi iarl"%w ry Writ 411Y an&(pr CESOG wutcnti.d have hat mllf I:d this waste bit cal Its any 6t her ha:atd ora we ste or waste air from Usher s•osrrce r.I agrre to accept she sddrdonal,hal yes fof dllomal <br /> of IL'L'S waste If the IRlormaSion I have I,ruvlded abour this wasw is War rect <br /> (All generators/custortlers MUST react the fallowing text and check the associated bpx.) <br /> If I a rR a i 11rJe gtldntl iy gcavral of.l Ire?ary Shat i i+aw a pr*gram ttf place to+educe llx.vohune and toaleity 6f t4ile 9 pWdWd 10 fhe u <br /> d Upee I h avp din cnined to ht economical 1),pe a rtir•able to d that I harp <br /> k•ktitrd the praCnralslr mlldlntf of ur�tP>:•nl,storage.a'disposatcurmnllyadottable to miswhich minpnt;ac th0llrMsenl,Ind•fu.rumthmal Io human Isle and thcenvnnnfralnl;•Or.If tam a small qu4r?oW g6netat sr,I <br /> havo Mack a gogd falsltrltwI to migy rnlae"waste genet atIon and•select the hest waste managomehl me 01w)that h;valLallo to me that tai+afford <br /> This individWl signing In lite space set ton It below on behalf of Custonier opmsents and wptrantt Ihat hrrshe ha siheauthod[yto bind Customer,that theIlpttom of waste and materials are trot and accurate <br /> as puka,ed,marked and blmled,are ready for.tvnmonation In accordarxe Nlth applicable stair and ft dzml regulaikm%s,Anil that Customer sha)I.thld hr iwnrsi y the StandardTerrns and Condipons on the revels, <br /> -side of this Service Older, //�1 r��J)}/{y /J•�J 'J �--f� <br /> / C tomer SttTi re llDate D ' 54gnature Date <br /> Print Name Print Drivers Name <br />