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FORSERVICE CALL: S)LKVK-L UKULK PARLIEP ASBURY ENVIRONMENTAL SERVICES, DBA ` FORM NO.WOES004-D (1/17) 559-498-0240 wo 500 SERVICE ORDER NO. FOR ACCOUNTING CALL: ©DIY 0 t 562-231-1550 N2479326 AF 110 WORLD OIL ENVIRONMENTAL SERVICES,. H ANTONINI ENTERPRISES LLC- LATHROP287 EAST MANNING AVE,PARLIER CA 93648 ANTONINI ENTERPRISES LLC-A P 701 D'ARCY PKWY 1-559-498-0240 PO BOX 8468 E WWW.WORLDOILCORP.COM LATHROP, CA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 95215 o (209) 993-8695 (209) 466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK,# CONTACT NAME ORDER TAKEN BY HALIDES ANT608 -ER-86 "2plY CHEDULE/JOHN ipacheca DATE REQUIRED DATE ENTERED NEXT SERVICE DATE P CUSTOMER EPA# BILL of LADING/MANIFEST# 11/27/2017 CAL0003857032 � n. � ' PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL 55-0/TM 55 GALLON O/T DRUM (RECONDITIONED) 2 OILY SO OILY SOLIDS PER DRUM 2 BATCH Cross Streets: TOTAL CASH RECD: CHECK# Account Manager: Steve Gately WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATEDT5DF: ALTERNATE TSDF: DRUMS P/U::72,-- EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE By signing below I hereby certify that: (S 1 DEC Z 2011 (Waste oil generator/customer MUST check ONE of the following thr boxes) 1 =111)I have not mixed any of the waste described above with any other hazardous waste,the total halide content Is LESS than 1,000 ppm,and the waste does not[ontai �I�''�s.I have carnplled with th�"rr� rfyy us of the applicable California used oil management regulations to determine this is true.I agree to accept the additional charges for the disposal of this waste ifthe Informatl 't�0II rfQ.. M =1#21 have not mixed any of the waste described above with any other hazardous waste,the total halide content Is GREATER than 1,000 ppm,and the waste does not contain any PCBs.I have provided proper documentation to World Oil Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste.I agree to accept the additional charges for the disposal ofthls waste if the information I have provided about this waste is incorrect Ok3)This waste is from a tank which collects waste oil from household"do-It-yourself"(DIY)and/or conditionally exempt small quantity generator(CESQG)sources.To the best of my knowledge,the only waste oil contained in my DIY/CESQG collection tank is soley from DIY and/or CESQG sources.I have not mixed this waste oil with any other hazardous waste or waste oil from other sources.I agree to accept the additional charges for disposal of this waste If the information I have provided about this waste is incorrect (All generators/customers MUST read the following text and check the associated box.) 141 If I-ma large quantity generator,I Wrtlfy chat!Dave a}x0gram In piaec to reduce the vahlme and toYlciiy al waste generated to the Degree I hasr determined to be economically practicable and that I have elected the practica*rnethdd of treatment,storage,or disposal currently available to rrw which minimlms the present and fat ure threat to human life and the environmenli Or,If I am a Small quanthy generator,I ! mach a good fatfh.effor t to minimize my waste generatbn and select the best waste managernent method that Is available to me that i canafford. This individual signing in the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer,that the forgoing descrlptions of waste and materlaIs are true and accurate as packaged,marked and labeled,are ready for transportation in accordancewith applicable state and federal regulations,and that Customer shall abide and be bound by the StandardTerms and Conditions on the reverse j side of th _ u Order, CU, I e Si not I CJate eriver [ natus Dater 9 Print Name T Wit bfillvers Na e