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FOR SERVICE CALL: SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) 559-498-0240 WO 500SERVICE ORDER NO. FOR ACCOUNTING CALL: WODIY 0C.'p 562-231-1550 N2488089 AF 110 WORLD OIL ENVIRONMENTAL SERVICES. H ANTONINI ENTE=RPRISES LLC- LATHROP287 EAST MANNING AVI„PARLIER CA 93648 PK," ENTERPRISES LLC-A P 1-55sa•�Sazao 701 D`ARCY " PO f30X 8468 E WWW.WORLDOILCORP.COM E T LATHR�7P,CA 95330 TRANSPORTER EPA#CAD028277036 STOCKfON, CA 95215• o (209) 993-8695 (209)466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIpES ANT608 ROUTE 124 14SCHEDULED-1 DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 12/15/2017 12113/2017 CAL000385703 3 h _yam PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL WOSC USED OIL SERVICE CHARGE 1 TV WO USED OIL/MIXED OILS 80 BATCH 4 Cro 1,5s Streets: TOTAL CASH RECD: CHECK# Account Manager,Steve Gately 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: DESIGNATE .� � OUN�OMME�A�ERVICC$CE-RES—tWZO- it*(DAl�11 D.7M , )5�#=tB S RL€3pQ J$�p ALTERNATETSDF: TSDF: DRUMS PIU: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) By signing below I hereby certify that: IF. i' v t (Waste oil generator/customer MUST check ONE of the following hree boxe",sn)) ��}}�� rt1)1 have not mired 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 c main aril P e�n1pi)cy} I the" fn rrtenss of the a{.�pliCable Callfornla used oil management regulations to determine this Is true.I agree to accept the additional charges For the disposal of this waste If the In mat,❑n ve prI ded a out t is waste is In�trect 4421 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 n t ❑ !p any PCBs I have provided proper documentation to World Oil Environmental Services to rebut the presumptlon that this waste was mixed with other hazardous waste.I agree c$ t t t'0r;[:A; �s� ai of this waste if the information I have provided about this waste Is incorrect Q 933This waste Is from a tank which collects waste 41 from household^da-ii•yourself'01Y)and/or conditionally exempt small quantity generator(CESQG)sotteces.To the best of my knowledge.the only waste oil contained In my DIYICEWG collection tank Is soley from DIY andlor CESQG sputces.I have not mined this waste oil with any other hazardous wasteor waste oil from other radices.-1 agree to accept the additional chotges 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.) Ir I am a large quantity generator I certify that I have a program in place tv reducethe volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatmenr,storage,or d5posal currentlyayailahle io mewhlch minlmues the present and future threat to hurnaii tire and the environment;Or,if I am a small quantity generator,I have made a goad faith effort to minimize my waste generation and select the best waste management method s.has Isavoilable tame that 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,thatthe ra g descriptions ofwaste and materials are true and accurate as packaged,marked and labeled,are ready for transportation in accordance with applicable state and federal regulations,and that Customershall ahl ori U wind by the Standard Terms and Conditions on the reverse side of this Service Order. �-� 2150/l Customer Signatt re Date iver gnature Date Pr(nt Name Print Drivers Name