Laserfiche WebLink
FOR SERVICE CALL: SERVICE ORDER <br /> PARUER ASB ' <br /> ,FIY. ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) <br /> C1 <br /> 559-498-0240 'W650 1 }� ��•: ERVICE ORDER NQ. <br /> FOR ACCOUNTING CALL: WODIY.O <br /> 562-231-1550 I~) d?.afia7 <br /> A F 128 <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,. <br /> H STOCKTON DODGE INC1428.7 EAST MANNING AVE,PARLIER CA 93648 <br /> I '- . -1;559-498-0240. <br /> p 3333 AUTO CENTER CIRCLE' PO BOX 8009 <br /> p WWWWORLDOILCORRCOM <br /> E <br /> T SfOCI{TQN,CA'95212 TRANSPORTER EPA#CAD0282,77036 STOCKTON,CA 95208 <br /> 0 (209) 477-38.68 (208)477-3688 <br /> CUSTOMER PURCHASE ORDER.#' ROUTE* TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> ST06.27 124• �(� �, SCHEDULED-1 <br /> DATE REQUIRED DATE ENTERED NEXT 5ERWCE DATE CUSTOMER EPA# BILL of LADING/MANIFEST A <br /> CA0981997@WO 0+7�� S!�.1 kl <br /> PART N DESCRIPTION' QTY UNIT-PRICE QTY P/U TOTAL <br /> wo USeD OIL/MIXED E711:8 .,:' 150 $0,00:' $0.00--. <br /> WOSC USED:OIL SERVle�CH-Ak� �E;':•- 1 s8Q00 X80.00 <br /> BATCH 01 <br /> C Stre@t5,. ,- ,. • .. � ... ,. TOTAL, •,, <br /> CASH RECD: CHECKS AE mxA 6Aanoger.Steve Gotaiyti <br /> WASTE DISPOSAL INFORMATION. <br /> NON-RCRA I4A7ARDOUS WASTE;LIQUID(USED OUJIMIXED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE <br /> OTHER: <br /> DESI'GNIITEPTSOF:-- ,BOURY4gP ,RONMENTAL-SERVICE-"gRE t9 0 N4nIEQA�tRQ; 'EIS Ak6#369� }64 ��8ri GA ' <br /> ALTERNATETSDF: <br /> DRUMS•P/,U; EMPTY DRUMS:„ FACILITY: BSC <br /> GENERATORWASCF CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) <br /> aystgnmg t�ytertlhtlub 1 , <br /> (Waste oil generator/customer MUST check ONE of the following thredboxes) <br /> n t1 I hard rnixr any or the waste described above with ally niher ftasardAL*Waste,the total halide csmient Is LESS than t,00o.ppm,and the wa tt:dors not contobs any I'cat.I have complied.with the requirements of ` <br /> the applkahrr Callfar rtsa UtL'd all ntana 9dKrMns reguiatEnns to dasornII a this is Vue.l spree to decept the additiaipi chaign foi rhedisismil of this wnrlr If the information I Iwm prwlJrd about this waste Is invorrn'i <br /> E]a2 i have not mixed any of the waste described above with a""her hazardous waste,the total halide content Is GREATER than I,W0 ppm,and the waste does not contain any Pais.I <br /> have prmided propite drxumentatkrn to World Oil Environme(7taf.Servlces lv rebut the presumption that thls waste was mixed with of her hazardous wader.I agree-to accept the addiIlonal charges for the disposal of lh)5 <br /> wale if the Irnarrlwtwn 1•6r"ptovrded ahorll this masse 4 oe.i Ircee: <br /> 1=11113)This waste is from a lankwhlch collects waste oil from household (61Y)and/or conditionally caenVIV salt quantity generator(CESOG)touices.To the best of rM knowledge,the only'vrliste oil contairsed - - <br /> inmyDIY/CESOG collection tank Is Soley from OIY and/or CESQG sources.I have not mixed this waste oil with any.olherlimlirdous waste orvraste oil from other sources.I agree toocrept_the idditloial chmric fr�r,dispgsal <br /> of this waste if the information I have provided about this waste Is Incorrect <br /> (All generators/ctastprners MUST read the fallowing text and check the associated box.) <br /> 4)If I am a large quantity"ritnalar 1 certify that E have a program In plAce to induce tlsC raiume and trrxlcity vlwattegrrte rated to the[Japee I have determined to t.N ttena(rkally piookable and that I have <br /> aclecle,Jthepractltabfenscthin)oflme lrrtont.sldragaadis,wsalcuirgrsi{y�avfilabletomewhtc!mlulmko,the presentars:futureNeat tohumanIdeaa+Jthe.envlronnturl:DrllIemasataRquantitygenerator,I <br /> haus omdc a goon lallh rflpt ra rnlalmirrmywastr gcncrallon.arid sdacs thebest waste rttanagerrncnl mcthsid shir is avarlabic to me Jsai I cartaffetd. <br /> This indlvidoai signing In the space set forth bekm on behalf of•Customer rnprrsents and:warmrus that he/she has the authority to bind Cruhtmr,r, t ugning descriptions of waste and materials are true and accurate <br /> as packaged,marked'and)a be led,are ready for vansportatlon In aecordanre with applicable stair and federal regulations.and that Customer: aide a be bound by the Stand a rd Terms and Conditions on the reverse <br /> "side of this Service Order. <br /> �Cust�nergnature Date r'• r erSignature Date <br /> �(Cilt Name rtnt Drivers Name <br />