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FOR SERVICE CALL: SERVICE ORDER [h/XON OFFICEpp50 ASBURY ENVIRONMENTAL, iH $,E,gy4CES, DBA FORM NO.WOES004-B (1/17) •r•ry.:,. • 1-86 WO .00-7-ASBURY � SERVICE QRDER NO. FOR ACGOUIVTW •CALL. V1 OO Y 0 - N?3933819 .562723,1-''155,0 - AF 1'25 WORLD OIL 'ENVIRONMENTAL SERVICES,. .H STOCKTON DODGE INC 7300 CHEVRON-WAY.oIXON GA P 95620 17806- -ASuRv3333 AUTO.CENTER CIRCLE r P0.Bt7X 8009• P Y.1 WWW.WORLDOILCORP.06M E STOCKTON CA 9521.2:•• k CADD28 7.703G STOCKTON.CA 9520$RANSAORTER EPA o 1`2497 41.7=389$ (209)477-3888 CUSTOMER�; PU�iCIiASE,Q,f�DER#'.. - �RQUTE?I TRACK#k CONTACT NAME ORDER TAKEN BY; HALIDES .: 51"0627 8410 ss. BILL RINf3I3zQU>?Z IDATE REQUIRED DATE ENTERED NEXT SERVICE-DATE CU5TOMER EPAII BJLL'of LAPINGIMANIF£S0 8t27/2017 W680 PART- DE5CR11'TiON QTY. UNIT PRICE IPTY PIU J .TOTAL. 55-C(TM, 65 GALLON'C/T"ME'•AL ORW(RC}NDITiQNED)..:. $52.00 $58_es MIXED MFXIYD FUELS PERMl]Ni � . ..$225.00 � $225.00 eAYcH TOTAL CASF,I'REC'D: WASTE D)SPO5AL INFORMATION ..NON-RCRA,HAZARDOUS WASTE,UQUO N5ED'61UINIXEQQILS) STATE CODE 22 t.: NDN-RCRA HAZARDOUS WATEr.L11 ;D'(ET•HYLENE GLYCOL SOLUTIONS) STATE CODE OTHER:. DE5IGNATEDT56F - - - AOIRNATE TSDF: C7RUfA5 PIU: EMPTY C]RUMS' FACILITY: I35C GENERATOR WASTE CERTIFICATION(PLEASE_CHECK THE APPROPRIATE BOX) Uy:Igmng below l hereby certify that (Waste oil generatorkustorner MUST check ONE of the following three boxes) =91)I have oat mixed.nry of the waste dc-wrlbird ahore lvlth odyolhcr hazarci"s'wasm the total halide rornem Is LESS dian%(Wpprn,and the wage does no ronlaIn ahy PCOs.I hive complied with the requtrumcrits,yf the applfcahlo Callfornia used oil managerndni regulations to deleTminc this it oue.l agcee td accept the addldonoi charges for thr,dispasal okhis waste If the Inrwmisfon I have prodded about this waste is incorrect' - dr:I hovrnas mi-cd any of Ilse rrassc drsedbed alsnve nitha iy other haiardous waste,tfic total Isai,de content it GREATER than UN ppm,and ihewilsw dues not mnlJrt any K11.0 hwcpmKdvdpropeldacums'ntouvuIOLYoddofCIWhORmenldfServl[osIdrelaidthe pme5 pdonIho.tthis wastewas nixedwllhOtherhazardous wade.Iagreetoacceptthe addidgmlcharges for thedisposalofthis vts3w If the InFarmaif is I have pravWed about dsli vaistd b Iticorrrct []td}lhlswasiCas►rtsmaswskwldchtalitictswaslruOfromhoutchnld5iu•i!-ycuesclf'(�f+'larullotcOiidldonallyr.rrmptuna4pWndlygcncrator(CESGf,)sources.To the best ofmyknnwk�ge,lfi4onlini:mg onla{ned In my pIY1 LE5pG callrepoll tank Is-splr;y h�m!']IY andlOrCI:SL}G'1Guxe1•I risen nal ml>tod thl!waste oil diith any tither ha7aerkus ivutre or wasio nil frarn other soultes.I arjreelo accept tho Jddillortal cdsatges Eut dlcpOsal of tizIs wa Relr thg fnformrrtion I have pcovloed shout this wmirt Is Inner"" (AII generators/custorners MUST read the fol lowirig text and chuck the associated bot.), ' .K!1.1 Aal If Tarn a large quantliy genHaw.I ce151fy 111311 Imw a prpgrom in ptarc to tedu[C the vok erne and tu.klve of+x'aste 9rnw m d to the degrha 1 have dertrmined so becconomrcatty prncdcaWe and that thaw ecctd rhe pracllCahio rnethnd a)1IrT.WItnt,itonge,or till pafal turrgnlly aairiabto to m8 Which minitr+i)cs the pl e.efn ant}future Threat W human life and the cryAronment:Or,h I ams srnafi quamley.gerserawt.1 to madea good'Ath effort to tnlnlmize rrvjws:te general Ian and refect dor btyt waste ntai'ragemont mui hod that Is available to me shut i can afford T1dt indhklval sYgning In the space srt forth Maw oil tebSll of Custa r tYapresrms and war ants that het:Ire Ims the avlharity to bind Customer,that the lvrgving denttiptiurls ptormte and trumials aro trudand accwate as fwkagttl,marked and labeled,arc ready for iransportatlon In accordance with applicable state and federal regubliom.and that customer shall abide and be bound n-y the 51andatd%tuts artdCondllimI On dsr Ferree srdc of blur Scrvlcc Cirdcr. • XrTgnattirg Date Driv r Ignalury Cr Print Name FY/~— Print Drivers ame I