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F'o.R SERVICE CALL: SERVICE ORDER <br /> PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) <br /> 559-498-0240 �/O 650• SERVICE ORDER NO. <br /> FOR ACCOUNTING CALL: WODIY 00 <br /> 562-231-4550` N243"4901 <br /> AF i 25 ' <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,. <br /> H STOCKfON DODGE INC 14287 EAST MANNING AVE,PARLIER CA 93648 - <br /> l 1-559-498-0240 <br /> P 3333 AUTO CENTER CIRCLE ''PO BOX 8009 : ' <br /> P WWW.WORLDOiLCORP.COM <br /> E- <br /> D STOWON,CA 95212 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 85708 <br /> o (209)477-3668 (209)477-3688' <br /> CUSTOMER# PURCHASE ORDER# RO.UTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> STO BV7 . 124 (,�b .b SCHEDULED4 <br /> (DATE REQUIRED DATE ENTERED NEXTSERVICE DATE CUSTOMER EPA k BILL of LADING/MANIFEST# <br /> 91-11/2017 917!2017 CAD9619676W <br /> PART# DESCRIPTION• QTY UNIT PRICE'; QTY P/U'; TOTAL <br /> WO: USED OIL f MIXEC]abs 450 $0.00. �ko $b.00 , <br /> WOSO USE6,OIL SERVICE CHARGE 1 $80.00 $80.00 <br /> MTg1f <br /> C SIX6pts� TOTAL_ <br /> CASH REC'D: CHECK k Acu utt Manager. Steve GMaI' <br /> WASTE DISPOSAL INFORMATION . <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STATE CODE 221 <br /> NO-DI-RCRA;HA7ARDOUS WASTE-LIQUID(IETH)LENE GLYCPL SOLUTIONS) STATE CQDC <br /> nTTiEFi:', r <br /> DE5IG�lAT U,T$DF: j� Ri`t' [V'IRC1�i143 1�[kS C�'R Oft[�41tI4C>r;GEit t +ttt@�; AttItlIT�036 '. <br /> ALTERNATE TDF-. <br /> DRUMS P/U: EMPTY DRUMS: FACILITY: BSC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) <br /> Fay signing below I hereby certify that: <br /> (Waste oil generator/customer MUST check ONE of the following three,boxes) <br /> I have-rn*d ony of the wastadetctiyed above wlih any other hx sir laus wane,d,a toral halitlerorktcmi m LES5 than 1.1100 pprn,and the waste don not rontafn any PCBs.I harp compiled with the requiruamits of <br /> the appllcabte California used oil na,aifemeet rcqula tions to detorrnirie this is true.!a9mo to accept shit additlanal.chwges for the disposal of this wa ue dthe Information I have ptovlded about this waste is irworreO <br /> V <br /> ORl l have not mixed any of the waste described above with any other hazardous.waste,the total In content is GREAT"than 1,000 ppm,and the waste does not contain any PCBs.I <br /> yeor' t <br /> havovtdmmi <br /> ed proper doo atfon to World011 Envlronme(ttal Services to rebut the presumption that this waste was mixed with other In wade.!agree to accept the additionatcharges for the disposal of Ihls <br /> 'wasip.lfWeInformation ilsat6tipravldcdabout thIswaste binea+riu. � � � ' � f� <br /> 0703)W5WaitelsflomnisnkwhlFhcdleeeswaslaoilfromhdt"huld'do-lhygprself'(DIY)and/or conditionally exempt small quantity.generator(CESQG)IOiNces.Tothe be'stofmyknowledge,the only.wastewleon4thied .. <br /> in rrry C?IYICiu Ow'611"llon l e nk l ioleyfrom <br /> Elly <br /> andlar CE5p6'eurce1.1 have not mixed this waste oil with,my other.hamrdaus waste or waste oil from dkior sources. agree to accept the addlliowlchalgasler dfspmal <br /> bf thlswage if the 114twnallarl I have provided about this waste If Ir.Kon"It <br /> �.,d (All generators/customers MUST react the following text and check the associated box.) <br /> Y-0l ti I am alarge fry andry rJpneratm.I certify Thal I harm a program In put to re atvcn the voume ind ready of wails generated to the.clegree I have delem+Iner1 to W Ccpnornlwlly pwtl Cd bte and th it I lave <br /> II -'card the praalrilllo mo Lhod.ol InWhtwnt,Slot aM or d1sposM-cunenrP <br /> lly adm e.;*ger <br /> Ab4 to me which nlmtm thmland future%hmat to human life and the MrvlfonmeM ter,if lam a 7m all yvansrly generalm,I <br /> In ammnde a good fakh effort to minimire my wavo general ion aryl se4ct the best rvaNe mann Vmer t method Ihat lsaaalfal+k to me that I can afford <br /> t <br /> This Individual sl fining in the space.set forth below on buhalf of Customer represenls and warran:5+hat halshe has she aulhwily to bind Customer,that the Fargo ing descriptions of waste and maleri.+Is arc truaarid occUrate <br /> as packaged,marked and labeled,are ready for transportat Ion In xcordnncp,wiih applicable stale and federal rrgulatlons,and that Customer shalt a an be bound by the Srandwi;Terms and Conditions w the reverse <br /> side of this Service Order. <br /> -jlc -� -—ly/A J7 <br /> "Customer Signature Date river ignature Da e e 11-7 <br /> L-W <br /> Print Name Tint Drivers Name <br />