COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

FOR SERVICE CALL: SERVICE ORDER j PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) 559-498-0240 VVO 500 1 SERVICE ORDER N0, FOR ACCOUNTING CALL: WODIY 0 1 N2604125 562-231-1550 AF 110 WORLD OIL ENVIRONMENT,A,L SERVICES,.. H ANTONINI ENTERPRISES LLC- LATHROPI[287 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 E T 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 JOHN avelazquez DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 6/27/2018 'Al 000385703 PART# DESCRIPTION QTY UNIT PRICE QTY P//U TOTAL 55-01TM 55 GALLON Off DRUM (RECONDITIONED) 2 OILY SO OILY SOLIDS PER DRUM 2 BATCH Cross Streets: TOTA L CASH RECD: CHECK# Account Manager Tadd Aurit WASTE DISPOSAL.INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATEDTSDF: ALTERNATE TSDF: DRUMS P/U:— _ EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE BOX) J By signing below I hereby certify that: JUL Ewa.ste Enmcol (Waste oil generator/customer MUST check ONE of the following three bo O>!1)I have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than LODI)ppm,and the waste does not conlaln any Pc s of the applicable California used oil management regulations to determine this)s true.I agree to accept the additional charges for the dlsposat of this waste if ibr informaIIon i have provided about this s O021 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 ham ptovided proper documentattori to world Oil Envlrofnrlehtal Se rvices to rebut the presumption that this waste was mixed with other hazardous waste.I agree to accept the additional charges for the disposal of this waste if the information I haw provided abou t this waste h Mofrn,3 #3)This waste is from a tank which collects waste oil from household"do-It-yourself"(DIY)and/or conditionally exelnpt small quantity generator(CESQG)sources.To the best of rhy knowledge,the only waste olI contained in my DIY/CESQ6collection tank Is coley 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 charg=s for c1hpuial 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.) 1-ix4)If I am a large gtrantlty genurator,i certify char I havr a program In place to reduce I hevolume and toxicity of waste generated to the degree I have determined to be economically practicable and that I)tavn scic;red the nractictible method of treatment,storage,or disposal cunently available to me which rnlnlmf esstha present and future threw to human life and the envirnnmenl;Or,if I am a small quanllty generator,I have madea good faith effort to minimize my wasle generation and select the best waste management method 010115 avaifabie to me Ihat i can afford. 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 descriptlnns a >>stcand materials are true and accurate as packaged,marked and labeled,are ready for transportation in accordance with applicable state and federal regulations,and that Customer shall abide and he bou d, I Itender erns and Conditions on the reverse side ofthis Service Or r, stoner Signa Date Driver Sig ' e Date - _ Print Name Print Dr}v N