COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

FOR SERVICE CALL: SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) 559-498-0240 VlfO 500 SERVICE ORDER N0. FOR ACCOUNTING CALL: WODIY 0lu 562-231-1550 N2467426 AF 110 WO[ZLD OIL ENVIRONMENTAL SERVICEST., H ANTONINI ENTERPRISES LLC- LATHR00287 EAST MANNING AVE,PARLIER CA 93648 ANTONINI ENTERPRISES LLC-A P 701 D'ARCY Pt VVY 1-559-498-0240 PO BOX$468 E WWW.WORLDOILCORP.COM 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 ROUTE 124 -Y&L SCHEDULED-] DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 11/6/2017 11/2/2017 CAL000385703 U r —/7 qS PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL WO USED OIL f MIXED OILS _ 040 456 WOSC USED OIL SERVICE CHARGE n U �� 1 BATCH Ik l 1 f 2� I Cro:s Streets; }- kO 0 TOTAL CASH REC'D: CHECK# t 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: DESIGNATEDTSDF: FtoNNtEMTAtSMV,�u#g QMBRGr @;�S�:A 5Ifi 9y i=t S k Y3l3B80 ALTERNATE TSDF: DRUMS P/U: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) Bysigning below lhereby certify that: a OV � � 211 (Waste oil generator/customer MUST check ONE of the following three boxes) N )I have not mixed any of the waste described above velih arty Other hatanleus waste the tmal halide content is LESS than 1,000 ppm,and the waste does not contain any PCBs.I have compiled with the requirements of 'the applicable CaMornia used oil management regulations to detarmine11114Is 1rue_1 agree to accept the addltional charges for the t1hposal of this waste if the information I have provided abuW this waste is Incorrect [7192 1 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 io 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 of this waste If site lnfotrnatlon I have provided about this waste Is Incorrect M#3)This waste Is from a tank which collects waste oil from household"do-lt•yaurself'(DIY)and/or conditionally exempt small quantity generalar(CESQG}wwces.To the best of my knowledge,the only waste oil contained in my m/cm-4 coitection tank is seley morn DIY and/or CHOG svurces.l havo not mixed this waste oil with any other hazardmx waste or waste oil from other sources.I agree to accept the additional charges for disposal tai this wash if the InfvrmaAvn I hatmpravided about this waste is incorrect (AlI generators/customers MUST read the following text and check the associated box.) }If I am a large quantity generator,I ter tlfy that I irdvea program In place to reduce the volume and toxicity of waste generated to the dxgree 1 have determined in he economically practicable and that I have selected th a practicable method of treatment,storage,or disposal correttlly8vallable to me which minimizes the present and ruture tlueat to human life and the envlroltmenf;or,if I am a small quantfty generator,I have made a gond faith effort to minlmize my waste generation and Wert the hest waste management method that is nvatiabfe to me that 1 tan afford, This individual signing In the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bindAu' ou.oe.bylhe ciptions of waste and materials are true and accurate as packaged,[narked and labeled,are ready for transportation In accordance with applicable state and federal regulations,and that Custhe Standard Terms and Conditions on the reverse serge of th4service or r. Cu rnfar Signa ore ❑ t�e bate to Arro PPVInt Name I Print Drivers Name