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` FOR SERVICE CALL: SERVICE ORDER FORM NO. WOES004-B(8/18) DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA 1-800.727-2879 SERVICE ORDER N0. FOR ACCOUNTING CALL: N2847925�' 562-231-1550 1�VOt�LD OIL }.' ENVIRONMENTAL SERVICES,. 7300 CHEVRON WAY, 95620 ANTONINI ENTERPRISES LLC-A � ANTONINI ENTERPRISES LLC-LATHROP CHEVWAY,1-aaa-r2r-2879 2879 P701 D'ARCY PKM PO LOX$468 E WWW.WORLDOILCORP.COM LATHROP, CA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 95215 0 (209) 993-8695 (209) 466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES tat a lrCfC-Cab JUNIN squintana DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# :6121/211.j1 S UALUUUJUb/U3 P BT# R R1P t QT UNIT PRICE QTY P/U TOTAL 56-CfF i 55 GALLON OfT DRUM (RECONDITIONED) 2 �-- JOHN 20, 66-4900 BATCH# TOTA L CASH REC°D:_._. CHECK,- #--.-WASTE DISPOSAL INFORMATION NON-RCRA HAZAR DOUS1 WASTE, LIQUID(USED OIL/MIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE ETHER: DESIGNATED TSDF: ;. ALTERNATE TSDF: T� _Cress a ts: Account onager:Sam Read DRUMS PN; EMPTY DRUMS: FACILITY. aSC a�1i a`T GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRI TE BR�I� 4 RECD By signing below 1 hereby certify that: (Waste oil generator/customer MUST check ONE of the following thre �pxes) : -—� #1)I have not mixed any of the waste described shave with any other hazardous waste,the total halide content is LESS than 1,440 ppm,and the waste ol�s norcon[ain any PCbs.I hnva complied with the requirements of the applicable Cal ifornla used oil management regulations to determine this Is true.I agree 10 accept the additional charges for the diepusal of this waste 11 the Information I have provided about this waste Is Incorrect, 0 121 have not mixed any of the waste described above with any other hazardous waste,the total halide content Is GREATER than 1,444 Ppm,and the waste does net contain any Pces.I have provided proper documentation to World Oil Environmenall Services to rebel the presumption that this waste was mixed with other hazardous waste.I agree to accept the udditiorw charges for thedtsposai of this waste If the Information I have provided about ItlW waste is tncormet #3)This waste Is from a tank which collects waste oil from household"do•Il•ycurself"(DIY)anWor conditionally exempt small quenlfty g¢' for(CESOO)sources.To the best of my knowledge,the onty waste all contained In MY MY/CESOG colieciton lank 16 soley from DIY andlor CESQG sources.i have not mixed this waata ail with any other hazardous waste or waste oil from other sourcoa.I agtee to accept She add[[lottal charges for disposal 01 this waste If f he Information I have provided about tills wasio Is Incorrect (All generators/customers MUST read the following text I certify that I have a program in place to reduce the volume end t)xlchy of waste genoraled to the degree I have determined to be economloafly practicable and that I have selected the practicable melliod of treatment,storage,or disposal c:urrentty available to me which minimizes lite present and fitiure threat to human life and the environment. Thin Individual signing In the space set rorth below an behalf of customer represents and warrants that Itr>laho has the out harity to bind customer,ihat tin torgalng dascrlptlons of waste and nfalerfala are true and a cnratr as Packaged,marked,and ino¢ied,ere ready for transporlatlon in ancordunt a with appllcabte stare and federal regufatlans, nd that sustamor shall abide by Itis Standard Terms and Condt[to ns an the reverse slam of this Scrvlt o Order, 5crvlca Orders wllh n ass rated hazardous w menll01A{either site sgecillc or consolidated)are subject to an EPA Fee.7hes twos cover the EPA pass-through fee and administration of the¢iA t hese fee ba n htanliestlype App Ices will appear on your hlliing Invoice. ustorner Signature Date Driver re Date