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01/15/2019 TUE 16156 FAX 0002/002
<br /> SERVICE ORDIF
<br /> FOR SERVICE CALL: - g
<br /> F'ARLJER :ASBURY ENVIRONMENTAL SERVICES,F�t r9 7 20 in r--ORM ND.w065004-D (11171
<br /> &0-498-0240 4'VCi � '' SERVICE ORDER NO.
<br /> FOR Ac NG CALL; W()C))Y " 1 1
<br /> 562-231
<br /> -ISSO-rsso ,;
<br /> 0- ENVIRONMENTAL
<br /> A� DEPARTMENT
<br /> VIVCU12�.9�.�7I1.
<br /> ENVIRONMF'NTAL SERVIC;ESo,
<br /> H JAOJAR HEAVEN AUTO.CII;7MAN7l_E:F�v 142B7EAS•I'MANNINICAVF,PARLIERCA93648
<br /> I 1-559.448.0240
<br /> a 1433 TILLIE LEWIS DRIVE 1453 TIL.LIE L,�WIS DRIVE
<br /> v WWW,W0RL0C II-rORRCOM
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<br /> STOCK-.'ON,CA 95206 TRANSPORTER EPA 0 CA002R277036 9TOCKTON, CA 95209
<br /> o (209)54,'2-4624 . (200)942-4524
<br /> CUSTOMER# PURCHASE ORDER ROUTE0 TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES
<br /> .JA(3C)OR 98 DAN aVelaxqueX '
<br /> DATE REQUIRED DATE ENTERED NEXT SERVICE DATO CUSTOMER EPA It BILL of LADING/MANIFESTO
<br /> 0/213/2017 CAL000050910
<br /> PART# DESCRIPTION QTY UNIT PRICE QTYP/U TOTAL
<br /> OFIDIN Oft.FILTER DRUM REPLACEEMENT-NC7 C,HARCIEi 1 $0,00 $0.f)Q
<br /> OF USED METAL OIL.AND GASOLINE Fl;TE--,R8 1 $65.00 555.00
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<br /> RATCW Yt .._......._.....
<br /> Cro•'Is Stroetm TOTAL
<br /> CASH REC'D; CHECK# ---.- )k.,;u'"mr Mlllydt4'd:gttivrt,Ldt&'ly .
<br /> WASTE DISPOSAL INFORMATION
<br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE CODE 221
<br /> NON-RCRA/I IAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE„_,,,,
<br /> SJk ._N LL'J:1L
<br /> DESIGNATED75Df;.�.t.l +— . ;...)..:.,,re.Ia.1__.a.,.__,...,)..,.r......,..;,;-...,�..r„_ .. ... .. . . . .... ..........__—.�_...._._,........._
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<br /> DRUMS Pl _.EMPTYDRUMS,
<br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX)
<br /> dv,igning Miaw thereby cn Nfymnu
<br /> (Waste oil generator/Customer MUST cheek ONE ofthe following thre0 boxes)
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<br /> (All generatom/customers MUT read the I>Ilr)vdirul t2xC and Chrr.k Ihe.c,rroc.iatecJ boxJ
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